Is anastomotic urethroplasty is really superior than BMG augmented dorsal onlay urethroplasty in terms of outcomes and patient satisfaction: Our 4-year experience

Choudhary, Anil K.; Jha, Nawal Kishore

doi:10.5489/cuaj.2291

Cited by 15 publications

(15 citation statements)

References 24 publications

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“…The success rate after BM urethroplasty was dependent on the used technique (68%‐87.5%). 13 A similar success rate with BM and EPA urethroplasty was found in other studies 14 , 15 and these success rates are comparable to our series. The variation between studies may be explained by differences in experience, used techniques, and definition of success or recurrence.…”

Section: Discussionsupporting

confidence: 92%

Do previous urethral endoscopic procedures and preoperative self‐dilatation increase the risk of stricture recurrence after urethroplasty?

Yildirim

Hennus

Wyndaele

et al. 2021

LUTS

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Objective To evaluate the relation between clinically relevant stricture recurrence after first urethroplasty and prior endoscopic treatments (dilatation and/or direct visual internal urethrotomy) or intermittent self‐dilatation (ISD). Methods Patients with bulbar urethral strictures treated with first urethroplasty between 2011 and April 2019 were included in a prospectively gathered database with standardized follow‐up. Stricture recurrence was defined as any need for reintervention. Primary outcome was the analysis of recurrence risk after first urethroplasty in relation with the number of prior endoscopic treatments or performance of ISD. Univariate and multivariate statistical analyses were performed. Results Overall, 106 patients were included with a median follow‐up of 12 months (interquartile range 8‐13]. Reintervention was necessary in 16 patients (15%). Recurrence was more prevalent in patients with ≥3 prior endoscopic treatments (28%, P = .009). No increased risk of recurrence was found in patients with 1 or 2 prior endoscopic treatments. The prevalence of prior ISD was twice as high in the stricture recurrence group (56% vs 26%, P = .014), and ISD was performed in 61% of the patients with ≥3 prior endoscopic treatments (P < .001). The number of prior endoscopic interventions and performance of ISD were no independent predictors for recurrence in the multivariable analysis. Conclusions This study shows that the risk of recurrence after first urethroplasty is increased in patients with ≥3 prior endoscopic treatments and in those who performed ISD. Patients performing ISD more often had ≥3 prior endoscopic treatments. Prior endoscopic treatment and performance of ISD were not independent predictors of stricture recurrence.

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Section: Discussionsupporting

confidence: 92%

Do previous urethral endoscopic procedures and preoperative self‐dilatation increase the risk of stricture recurrence after urethroplasty?

Yildirim

Hennus

Wyndaele

et al. 2021

LUTS

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“…Penile location is considered to cause graft necrosis and retraction due to weak vascular support tissue and it is reported that penile or neighboring tissue flaps provide better results. 15 Additionally, EPA may cause curvature and shortening of the penis due to resection. However, in our series, as EPA was applied for stricture less than 1 cm in size in the penile region, we did not encounter this complication.…”

Section: Discussionmentioning

confidence: 99%

Outcomes and predictive factors for re-stricture with urethroplasty methods for anterior urethra stricture

Güler

2023

Urologia

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Objectives: We wished to compare the treatment success of urethroplasty methods (EPA and BMG) used for anterior urethra stricture after unsuccessful internal urethrotomy. Methods: A total of 85 and 51 patients, respectively, who underwent excision and primary anastomosis (EPA) and buccal mucosal graft (BMG) urethroplasty due to recurrent strictures after direct vision internal urethrotomy (DVIU) were evaluated retrospectively. On the uroflowmetry test, >15 ml/s urine flow and residual urine (PVR) below 50 ml were determined as success criteria. Cox regression analysis investigated the probable predictive factors for surgery success. Kaplan-Meier analysis assessed stricture free survival after redo-urethroplasty. Results: After surgery, EPA and BMG patients were followed for 31.9 ± 9.8 (4–40) and 30.7 ± 10.3 (4–40) months. At the end of this follow-up duration, success was obtained for 71 (83.5%) and 44 (86.3%) patients. Mean re-stricture times were 13.9 ± 6.0 (4–19) and 10.2 ± 5.1 (4–26) months. Most re-strictures had penile location (10 (71.5%) and 7 (100%)). After one session of DVIU, there was 100% success in both groups, but after >3 sessions of DVIU, success fell to 70.3% and 78.3% in the groups respectively. Patients with high numbers of DVIU sessions had longer durations for urethroplasty surgery. Apart from complications related to the donor field in the oral region with BMG and four patients who developed fistula (7.8%), complications were similar in both groups. Conclusions: In this series of cases, it was not possible to identify which of the techniques employed provides the best result or predictive factors for stenosis recurrence after correction procedures for anterior urethral stenosis.

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“…Choudhary AK et al [19]. and Hussain et al [5] found Incidence of erectile dysfunction in 6.66% and 5.0% respectively.…”

Section: Discussionmentioning

confidence: 99%

Outcome of Anastomotic Urethroplasty: Single-Center Experience

Faruque¹,

Islam²,

Alam³

et al. 2020

Bang J Urology

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Objective: To determine the short term outcome of anastomotic urethroplasty. Material and Methods: From January 2013 to June 2015, 25 male patients underwent anastomotic urethroplasty at our center and were analyzed prospectively. Mean age was 28.1 years (range 13-50), average stricture length was 2.5 cm (range 1.5-2.5). Patients with post-prostatectomy stricture, stricture more than 2.5 cm in length or patients of stricture with neurogenic bladder and patients with any perineal disease were excluded from the study. Retrograde urethrogram and voiding cysto-urethrogram was done in every patient to assess stricture length and location. Stricture excision and end-to-end anastomosis of urethra with spatulation was performed in every patient. Minimum followup period was 6 months and maximum 30 months. All patients had obliterative stricture. Results: The mean operative time was 105 min (range 90-120). Four patients (16%) developed complications postoperatively. Wound infection occurred in 01 (04%) patient. Stricture recurrence found in 02 (08%) patients and erectile dysfunction in 01 (04%) patients. Twenty one patients (84%) had excellent outcome, Two (08%) needed optical internal urethrotomy and of them one (04%) failed to respond. Conclusion: Anastomotic urethroplasty has a high success rate of 92%. It is technically straightforward with minimal morbidity. Long term follow-up is strongly recommended for ultimate success. Bangladesh Journal of Urology, Vol. 19, No. 1, Jan 2016 p.38-42

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Is anastomotic urethroplasty is really superior than BMG augmented dorsal onlay urethroplasty in terms of outcomes and patient satisfaction: Our 4-year experience

Cited by 15 publications

References 24 publications

Do previous urethral endoscopic procedures and preoperative self‐dilatation increase the risk of stricture recurrence after urethroplasty?

Do previous urethral endoscopic procedures and preoperative self‐dilatation increase the risk of stricture recurrence after urethroplasty?

Outcomes and predictive factors for re-stricture with urethroplasty methods for anterior urethra stricture

Outcome of Anastomotic Urethroplasty: Single-Center Experience

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