title: Critical Analysis of Patient-reported Complaints and Complications After Urethroplasty for Bulbar Urethral Stricture Disease.
abstract: OBJECTIVE
  To evaluate the full spectrum of postoperative complications and patient-reported complaints after urethroplasty for bulbar urethral stricture disease.
  
  
  METHODS
  We performed a retrospective review of our institutional database for all patients who underwent urethroplasty from January 1, 2002 to December 1, 2012. We recorded all postoperative complications and patient-reported complaints and grouped them by the Clavien-Dindo classification of surgical complications and into the following categories: perioperative, infectious, anatomic, sexual dysfunction, and voiding related. The Fisher exact test was used to calculate statistical differences among repair types and etiology.
  
  
  RESULTS
  Three hundred twenty-five men underwent urethroplasty by 2 surgeons (G.D.W. and A.C.P.) during the period reviewed. Two hundred ninety-two of 325 men (90%) had sufficient follow-up data available. One hundred eleven of 292 men (38%) reported a total of 146 postoperative complications or complaints. Forty-seven of 111 men (42%) were classified as having a perioperative complication, 17 of 111 (15.3%) as infectious, 8 of 111 (7.2%) as anatomic, 29 of 111 (26.1%) as sexual dysfunction, and 32 of 111 (28.8%) as voiding related. The majority of complications were classified as Clavien grade I (87 of 146, 60%). Forty-seven of 146 men (32%) were classified as having Clavien grade II, 9 of 146 (6%) as grade III, and 3 of 146 (2%) as grade IV. There were no grade V complications. Patients with iatrogenic etiology had a higher rate of infectious-related complications when compared with idiopathic or traumatic (17.5% vs 3.7%, 4.8%, respectively; P = .008).
  
  
  CONCLUSIONS
  Urethroplasty continues to have excellent outcomes with acceptable complication rates, the majority of which are self-reported complaints about voiding, scrotal and/or perineal neuralgia, and sexual dysfunction and appear to have minimal long-term sequelae.
authors: Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC. Electronic address: Michael.Granieri@duke.edu.
authors: Michael A
authors: MA
authors: Granieri
authors: Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC.
authors: George D
authors: GD
authors: Webster
authors: Division of Urologic Surgery, Department of Surgery, Duke University Medical Center, Durham, NC.
authors: Andrew C
authors: AC
authors: Peterson
mesh_terms: D059026:Diagnostic Self Evaluation; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000473:pathology / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects / Q000379:methods