One‑stage Anastomotic Urethroplasty for Traumatic Urethral Strictures. January 2004–January 2013

Abstract

Purpose: One‑stage anastomotic urethroplasty is an attractive procedure for reconstructing the urethra following trauma. This prospective study highlights the advantages of the procedure and outcome of treatment.

Materials and Methods: A total of 87 patients, age range 11–68 years with a mean of 35.4 years were included in the study. These patients were seen at two tertiary Institutions in South East Nigeria. The stricture lengths varied between 0.8 cm and 3.2 cm. All had suprapubic cystostomy initially followed by an end to end perineal anastomosis after thorough work up. Preoperatively 9 (10.3%) patients had impotence from the trauma. Postoperatively the patients were assessed with peri‑catheter retrograde urethrogram, micturating cystourethrogram, and uroflowmetery.

Results: All the patients were males. At 6 months, 13 out of 21 (62%) patients who had bulbo‑prostatic anastomosis and 62 out of 66 (94%) patients that had bulbo‑membranous, bulbo‑bulbar anastomosis had satisfactory micturition with urine flow rate >15 ml/s. Totally, 12 (13.8%) patients had urine flow rate of <12 ml/s. At 1‑year, there were 12 re‑strictures, no urinary incontinence and four cases of a decrease in the strength of penile erection that needed no treatment.

Conclusion: Delayed one‑stage anastomotic urethroplasty provides for decreased incidence of postoperative morbidity, re‑stricture, impotence and urinary incontinence for most short segment posttraumatic urethral strictures.

Keywords: One‑stage anastomotic urethroplasty, pelvic trauma, urethral trauma