Nontransecting Anastomotic Repair in Urethral Reconstruction: Surgical and Functional Outcomes.
We evaluated the surgical and functional outcomes, and the effect of the learning curve of nontransecting anastomotic repair for short bulbar and posterior urethral strictures.



A total of 75 patients were treated with nontransecting anastomotic repair for short bulbar strictures in 55 and for posterior strictures in 20. Surgical morbidity was scored using the Clavien-Dindo classification at 3 months. Sexual function was measured using SHIM (Sexual Health Inventory for Men) scoring preoperatively and postoperatively. Post-void dribbling before and after nontransecting anastomotic repair was also determined. To evaluate the learning curve outcomes were evaluated in patients 1 to 25, 26 to 50 and 51 to 75.



Median followup was 30 months. Stricture recurred in 6 patients (8%), all diagnosed within 7 months after nontransecting anastomotic repair. Median operative time was 95 minutes and median hospital stay was 2 days. In 61 patients (81.3%) no surgical morbidity was recorded. Five (6.7%), 6 (8%) and 3 patients (4%) experienced a grade 1, 2 and 3b complication, respectively. Seven of 32 (21.9%) and 2 of 42 evaluable patients (4.7%) reported de novo erectile dysfunction and post-void dribbling, respectively, 3 months after nontransecting anastomotic repair. No difference in outcomes was observed among the 3 patient groups.



Nontransecting anastomotic repair appears to be safe without a substantial learning curve effect. Patient counseling about possible surgical complications and transient erectile dysfunction is important.
Department of Urology, Ghent University Hospital, Ghent, Belgium. Electronic address: nicolaas.lumen@uzgent.be.
Nicolaas
N
Lumen
Department of Urology, Ghent University Hospital, Ghent, Belgium.
Filip
F
Poelaert
Department of Urology, Ghent University Hospital, Ghent, Belgium.
Willem
W
Oosterlinck
Department of Urology, Ghent University Hospital, Ghent, Belgium.
Edward
E
Lambert
Department of Urology, Ghent University Hospital, Ghent, Belgium.
Karel
K
Decaestecker
Department of Urology, Ghent University Hospital, Ghent, Belgium.
Thomas
T
Tailly
Department of Urology, Ghent University Hospital, Ghent, Belgium.
Piet
P
Hoebeke
Department of Urology, Ghent University Hospital, Ghent, Belgium.
Anne-Françoise
AF
Spinoit
D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods*; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D059032:Learning Curve; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D012008:Recurrence; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery; D014525:Urethral Stricture / Q000601:surgery*; D014549:Urinary Incontinence / Q000453:epidemiology / Q000209:etiology
anastomosis; complications; erectile dysfunction; recurrence; surgical; urethral stricture