Urethroplasty Improves Overactive Bladder Symptoms in Men with Anterior Urethral Strictures

To assess the effect of urethroplasty on overactive bladder symptoms.

From March 2011 to November 2014, 47 anterior urethroplasties were performed by a single surgeon. (RSP) Of these, 42 men prospectively completed the validated overactive bladder symptoms score (OABSS) prior to and after urethroplasty. Comparative analysis of preoperative to postoperative OABSS results was performed.

The median (range) age of men who comprised our cohort was 49 (22-90). Questionnaires were completed preoperatively and at a median of 12 months (2.3-74.6) postoperatively. Stricture location included: bulbar (75%), penile (15%), and membranous (7.5%) urethra. Median stricture length was 3 cm (1-6). Half of men underwent an excision and anastomotic repair and half underwent buccal mucosal graft. Men experienced significant improvement in urinary flow rate, postvoid residual urine, and overactive bladder symptoms reported on the OABSS. Of the 28/42 men with preoperative, clinically significant overactive bladder (i.e. OABSS ≥ 8), 25/28 reported a 54.2% (0-100%) median reduction in OABSS with only one patient reporting worsening of symptoms following surgery. Those men with the highest preoperative OABSS experienced the greatest improvement in OAB symptoms postoperatively.

In men with anterior urethral strictures and OAB, urethroplasty decreased reported OABSS by > 50% and cured 90% of men with clinically significant overactive bladder symptoms.

Urology. 2016 Apr 07 [Epub ahead of print]

E Charles Osterberg, Michael Schulster, Jerry G Blaivas, Avinash Maganty, Daniel J Lee, Rajveer S Purohit

University of California - San Francisco. Electronic address: ., Weill Cornell Medical College., Weill Cornell Medical College., University of Pittsburgh Medical Center., Weill Cornell Medical College., Weill Cornell Medical College.