title: Primary non-transecting bulbar urethroplasty long-term success rates are similar to transecting urethroplasty.
abstract: OBJECTIVE
  To review the long-term outcomes of transecting versus non-transecting urethroplasty to repair bulbar urethral strictures.
  
  
  METHODS
  A retrospective review was conducted of 342 patients who underwent anterior urethroplasty performed by a single surgeon from 2003 to 2014. Patients were excluded from further analysis if there had been prior urethroplasty, stricture location outside the bulbous urethra, or age <18 years. In the transecting group, surgical techniques used included excision and primary anastomosis and augmented anastomotic urethroplasty. In the non-transecting group, surgical techniques used included non-transecting anastomotic urethroplasty and dorsal and/or ventral buccal grafting. The primary endpoint was stricture resolution in transecting vs. non-transecting bulbar urethroplasty. Success was defined as freedom from secondary procedures including dilation, urethrotomy, or repeat urethroplasty.
  
  
  RESULTS
  One hundred and fifty-two patients met inclusion criteria. At a mean follow-up of 65 months (range: 10-138 months), stricture-free recurrence in the transecting and non-transecting groups was similar, 83% (n = 85/102) and 82% (n = 41/50), respectively (p = 0.84). Surgical technique (p = 0.91), stricture length (p = 0.8), and etiology (p = 0.6) did not affect stricture recurrence rate on multivariate analysis. There was no difference detected in time to stricture recurrence (p = 0.21).
  
  
  CONCLUSIONS
  In this retrospective series, transecting and non-transecting primary bulbar urethroplasty resulted in similar long-term stricture resolution rate. Prospective studies are needed to determine what differences may present in outcomes related to sexual function and long-term success.
authors.affiliation: Division of Urology, University of Colorado Denver, Academic Office One Bldg. 12631 East 17th Ave, Box C319, Aurora, CO, 80045, USA.
authors.forename: Kirk M
authors.initials: KM
authors.lastname: Anderson
authors.affiliation: Division of Urology, University of Colorado Denver, Academic Office One Bldg. 12631 East 17th Ave, Box C319, Aurora, CO, 80045, USA.
authors.forename: Stephen A
authors.initials: SA
authors.lastname: Blakely
authors.affiliation: Division of Urology, University of Colorado Denver, Academic Office One Bldg. 12631 East 17th Ave, Box C319, Aurora, CO, 80045, USA.
authors.forename: Colin I
authors.initials: CI
authors.lastname: O'Donnell
authors.affiliation: Department of Urology, State of New York Upstate Medical University, Upstate University Hospital, 750 East Adams Street, Syracuse, NY, 13210, USA.
authors.forename: Dmitriy
authors.initials: D
authors.lastname: Nikolavsky
authors.affiliation: Division of Urology, University of Colorado Denver, Academic Office One Bldg. 12631 East 17th Ave, Box C319, Aurora, CO, 80045, USA. brian.flynn@ucdenver.edu.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Flynn
mesh_terms: D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D012008:Recurrence; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000473:pathology / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods
keywords: Anterior; Bulbar; Urethra; Urethral stenosis; Urethral stricture; Urethroplasty