title: Short-term outcome and morbidity of different contemporary urethroplasty techniques--a preliminary comparison.
abstract: OBJECTIVE
  Only few comparative reports about different urethroplasties have been published, addressing success rate (SR), adverse events (AE), and quality of life (QoL). Our purpose was to evaluate SR, AE, and QoL in a contemporary cohort of patients undergoing urethroplasty in the short-term follow-up (FU).
  
  
  METHODS
  Between December 2008 and June 2010, 205 patients underwent urethroplasty for anterior urethral strictures at our institution. A standardized questionnaire was sent to all patients. The primary end point was SR. Secondary end points were AE and QoL. To assess the risk of SR, the Kaplan-Meier method and log-rank test were used. To assess risk factors for urethral stricture recurrence (SRec), univariable Cox regression analysis was used.
  
  
  RESULTS
  Overall, 140 (68%) patients responded to our questionnaire and were used for analysis. Of these 9%, 85%, and 6% were treated by excision and primary anastomosis (EPA), buccal mucosa graft urethroplasty (BMGU), and mesh graft urethroplasty (MGU), respectively. At 10 months of FU, SR was 87.5%. SRs of EPA, BMGU, and MGU were 100% (n=13/13), 85.7% (n=102/119), and 87.5% (n=7/8), with no significant differences between the groups. In univariable analysis, ≥ 2 vs 1 previous urethroplasties showed a trend toward a reduced SR (hazard risk 2.95; P=0.057). Streaking the urethra (P=0.024) and penile curvature (P=0.026) were significantly more often associated with MGU compared with EPA and BMGU. Postoperative total median (mean) scores were 3.5 (4.8) for the International Consultation on Incontinence Questionnaire Male lower urinary tract symptoms, 15 (15.2) for the International Index of Erectile Function, and 80 (73) for EuroQol visual analogue score; there was no difference between urethroplasty types.
  
  
  CONCLUSIONS
  In the short-term FU, urethroplasty demonstrates an excellent SR. Specific SRs of EPA, BMGU, and MGU seem comparable. Despite significant differences in AE, patient reported QoL is high with no difference between the applied techniques.
authors.affiliation: Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. L.Kluth@ uke.de
authors.forename: Luis A
authors.initials: LA
authors.lastname: Kluth
authors.forename: Roland
authors.initials: R
authors.lastname: Dahlem
authors.forename: Philip
authors.initials: P
authors.lastname: Reiss
authors.forename: Daniel
authors.initials: D
authors.lastname: Pfalzgraf
authors.forename: Andreas
authors.initials: A
authors.lastname: Becker
authors.forename: Oliver
authors.initials: O
authors.lastname: Engel
authors.forename: Felix K-H
authors.initials: FK
authors.lastname: Chun
authors.forename: Margit
authors.initials: M
authors.lastname: Fisch
authors.forename: Sascha A
authors.initials: SA
authors.lastname: Ahyai
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity / Q000639:trends; D009061:Mouth Mucosa / Q000637:transplantation*; D011183:Postoperative Complications / Q000453:epidemiology*; D011788:Quality of Life; D019651:Plastic Surgery Procedures / Q000379:methods*; D012008:Recurrence; D012189:Retrospective Studies; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000503:physiopathology / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods*; D055815:Young Adult