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. 2012 Dec;188(6):2260-4.
doi: 10.1016/j.juro.2012.07.101. Epub 2012 Oct 22.

Repeat urethroplasty after failed urethral reconstruction: outcome analysis of 130 patients

Sarah D Blaschko  1 , Jack W McAninch, Jeremy B Myers, Bruce J Schlomer, Benjamin N Breyer
Affiliations

Repeat urethroplasty after failed urethral reconstruction: outcome analysis of 130 patients

Sarah D Blaschko et al. J Urol. 2012 Dec.

Abstract

Purpose: Male urethral stricture disease accounts for a significant number of hospital admissions and health care expenditures. Although much research has been completed on treatment for urethral strictures, fewer studies have addressed the treatment of strictures in men with recurrent stricture disease after failed prior urethroplasty. We examined outcome results for repeat urethroplasty.

Materials and methods: A prospectively collected, single surgeon urethroplasty database was queried from 1977 to 2011 for patients treated with repeat urethroplasty after failed prior urethral reconstruction. Stricture length and location, and repeat urethroplasty intervention and failure were evaluated with descriptive statistics, and univariate and multivariate logistic regression.

Results: Of 1,156 cases 168 patients underwent repeat urethroplasty after at least 1 failed prior urethroplasty. Of these patients 130 had a followup of 6 months or more and were included in analysis. Median patient age was 44 years (range 11 to 75). Median followup was 55 months (range 6 months to 20.75 years). Overall, 102 of 130 patients (78%) were successfully treated. For patients with failure median time to failure was 17 months (range 7 months to 16.8 years). Two or more failed prior urethroplasties and comorbidities associated with urethral stricture disease were associated with an increased risk of repeat urethroplasty failure.

Conclusions: Repeat urethroplasty is a successful treatment option. Patients in whom treatment failed had longer strictures and more complex repairs.

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Figures

Figure 1
Figure 1
Figure Number of repeat urethroplasty failures with time. Most failures occurred in first 2 years after surgery. One occurred 16 years after reoperation, reinforcing need for long-term followup for patients with urethroplasty.
See this image and copyright information in PMC

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