title: Limited experience, high body mass index and previous urethral surgery are risk factors for failure in open urethroplasty due to penile strictures.
abstract: OBJECTIVE
  The aim of this study was to evaluate outcomes and possible risk factors for failure of open urethroplasty due to penile urethral strictures.
  
  
  METHODS
  A retrospective chart review was undertaken of 90 patients with penile stricture undergoing 109 open urethroplasties between 2000 and 2011. In 80 urethroplasties, a one-stage procedure was performed: 68 of these had a pediculated penile skin flap, nine had a free buccal mucosal graft and three had a free skin graft. A two-stage procedure using buccal mucosa was performed in 29 urethroplasties. Failure was defined as when further urethral instrumentation was needed.
  
  
  RESULTS
  The mean age in the one-stage and two-stage groups were 50 and 54 years, respectively. The success rates in the corresponding groups were 65% and 72%, with follow-up times of 63 and 40 months, respectively. Multivariable analyses disclosed body mass index (BMI) and previous urethral surgery to be significant risk factors for failure in the one-stage group. Failure over time significantly decreased during the study period.
  
  
  CONCLUSIONS
  Both one- and two-stage penile urethroplasty demonstrated success rates in line with previous reports. Limited experience, high BMI and previous urethral surgery appear to be associated with less favourable outcome.
authors: a Department of Urology, Sahlgrenska University Hospital, Institute of Clinical Sciences at Sahlgrenska Academy , Gothenburg, Sweden.
authors: Teresa O
authors: TO
authors: Ekerhult
authors: a Department of Urology, Sahlgrenska University Hospital, Institute of Clinical Sciences at Sahlgrenska Academy , Gothenburg, Sweden.
authors: Klas
authors: K
authors: Lindqvist
authors: a Department of Urology, Sahlgrenska University Hospital, Institute of Clinical Sciences at Sahlgrenska Academy , Gothenburg, Sweden.
authors: Ralph
authors: R
authors: Peeker
authors: a Department of Urology, Sahlgrenska University Hospital, Institute of Clinical Sciences at Sahlgrenska Academy , Gothenburg, Sweden.
authors: Lars
authors: L
authors: Grenabo
mesh_terms: D000328:Adult; D015992:Body Mass Index; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation; D010409:Penile Diseases; D010413:Penis / Q000601:surgery*; D012189:Retrospective Studies; D012307:Risk Factors; D013524:Surgical Flaps; D017211:Treatment Failure; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male
keywords: BMI; clinical experience; risk factors; urethral stricture; urethroplasty