Recurrent rate of urethral stricture after urethroplasty in Rajavithi Hospital
Keywords:Yanang, hydrocolloid, waxy rice flour, pasting properties, textural properties, RVA
Objective: We studied the surgical outcomes of urethroplasty in our center and the risk factors for recurrent urethral stricture after urethroplasty.
Material and method: We retrospectively reviewed all patients with urethral stricture who underwent urethroplasty in Rajavithi Hospital between January 2008 and December 2014. Recurrent stricture was defined as the need to use postoperative instrumentation. Chi-square test or Fisher exact test was used to assess the significance of risk factors for recurrence.
Result: Mean patient age was 37.8±15.7yr. Mean BMI was 22.1±4.5 kg/m2. The etiology of urethral stricture was trauma (83%). The stricture site was located at anterior urethra (52%) and posterior urethra (43%). Mean stricture length was 1.75±0.92 cm. End-to-end anastomosis was performed in 82%, flap urethroplasty in 17%, and two stage urethroplasty in 1%. Mean operative time was 219.8±68 min. Recurrence occurred in 28% at a mean time of 6.66±12.7 months. Treatments after recurrence were urethral dilation 57.1%, direct visual internal urethrotomy 17.9%, urethroplasty 14.3%, and suprapubic cystostomy 10.7%. We found no association of the risk factors and recurrent stricture in our study.
Conclusion: Recurrence rate after urethroplasty was 28% in our study. Mean time to recurrence was 6.6 months. We found no association of the risk factors and recurrent stricture in our study.
2. Romero Pérez P, Mira Llinares A. Complications of the lower urinary tract secondary to urethral stenosis. Actas Urol Esp 1996;20:786-793.
3. Santucci RA, Joyce GF, Wise M. Male urethral stricture disease. J Urol 2007;177:1667-1674.
4. Stein DM, Thum DJ, Barbagli G, et al. A geographic analysis of male urethral stricture aetiology and location. BJU Int 2013;112:830- 834.
5. Alwaal A, Blaschko SD, McAninch JW, Breyer BN. Epidemiology of urethral strictures. Transl Androl Urol 2014;3:209-213.
6. Mundy AR, Andrich DE. Urethral strictures. BJU Int 2010;107:6-26.
7. Tinaut-Ranera J, Arrabal-Polo MA, Merino-Salas S, et al. Outcome of urethral strictures treated by endoscopic urethrotomy and urethroplasty. Can Urol Assoc J 2014;8(1-2):e16-19.
8. Gimbernat H, Arance I, Redondo C, et al. Analysis of the factors involved in the failure of urethroplasty in men.Actas Urol Esp 2014;38: 96-102.
9. Barbagli G, Palminteri E, Bartoletti R, et al. Long-term results of anterior and posterior urethroplasty with actuarial evaluation of the success rates. J Urol 1997;158:1380-1382.
10. Kinnaird AS, Levine MA, Ambati D, et al. Stricture length and etiology as preoperative independent predictors of recurrence after urethroplasty: A multivariate analysis of 604 urethroplasties. Can Urol Assoc J 2014;8(5-6): e296-300.
11. Breyer BN, McAninch JW, Whitson JM, et al. Multivariate analysis of risk factors for longterm urethroplasty outcome. J Urol 2010; 183: 613-617.
12. Barbagli G, De Angelis M, Romano G, et al. Long-term follow up of bulbar end-to-end anastomosis: a retrospective analysis of 153 patients in a single center experience. J Urol 2007;178:2470-2473.
13. Jun-Gyo Suh, Woo Suk Choi, Jae-Seung Paick, et al. Surgical Outcome of Excision and End-toEnd Anastomosis for Bulbar Urethral Stricture. Korean J Urol 2013;54:442-447.
14. Micheli E, Ranieri A, Peracchia G, et al. Endto-end urethroplasty: Long-term results. BJU Int 2002;90:68-71.
15. Vashishtha S, Sureka SK, Kumar J, et al. Predictors for recurrence after urethroplasty in pediatric and adolescent stricture urethra. J Pedriatric Urolog 2014;10:268-273.
16. Jose Luis Lozano Ortega and Carlos Pertusa Peña, et al:Surfical treatment of urethral stenosis. Results of 100 urethroplasties. Arch Esp Urol 2009;62:109-114.