Primary non-transecting bulbar urethroplasty long-term success rates are similar to transecting urethroplasty.

To review the long-term outcomes of transecting versus non-transecting urethroplasty to repair bulbar urethral strictures.

A retrospective review was conducted of 342 patients who underwent anterior urethroplasty performed by a single surgeon from 2003 to 2014. Patients were excluded from further analysis if there had been prior urethroplasty, stricture location outside the bulbous urethra, or age <18 years. In the transecting group, surgical techniques used included excision and primary anastomosis and augmented anastomotic urethroplasty. In the non-transecting group, surgical techniques used included non-transecting anastomotic urethroplasty and dorsal and/or ventral buccal grafting. The primary endpoint was stricture resolution in transecting vs. non-transecting bulbar urethroplasty. Success was defined as freedom from secondary procedures including dilation, urethrotomy, or repeat urethroplasty.

One hundred and fifty-two patients met inclusion criteria. At a mean follow-up of 65 months (range: 10-138 months), stricture-free recurrence in the transecting and non-transecting groups was similar, 83% (n = 85/102) and 82% (n = 41/50), respectively (p = 0.84). Surgical technique (p = 0.91), stricture length (p = 0.8), and etiology (p = 0.6) did not affect stricture recurrence rate on multivariate analysis. There was no difference detected in time to stricture recurrence (p = 0.21).

In this retrospective series, transecting and non-transecting primary bulbar urethroplasty resulted in similar long-term stricture resolution rate. Prospective studies are needed to determine what differences may present in outcomes related to sexual function and long-term success.

International urology and nephrology. 2016 Nov 14 [Epub ahead of print]

Kirk M Anderson, Stephen A Blakely, Colin I O'Donnell, Dmitriy Nikolavsky, Brian J Flynn

Division of Urology, University of Colorado Denver, Academic Office One Bldg. 12631 East 17th Ave, Box C319, Aurora, CO, 80045, USA., Department of Urology, State of New York Upstate Medical University, Upstate University Hospital, 750 East Adams Street, Syracuse, NY, 13210, USA., Division of Urology, University of Colorado Denver, Academic Office One Bldg. 12631 East 17th Ave, Box C319, Aurora, CO, 80045, USA. .