End-to-end urethroplasty: long-term results.

Abstract

To retrospectively review patients with strictures (<3 cm) of the bulbous urethra who had undergone urethroplasty with excision of the stenotic segment and end-to-end anastomosis. The review included 74 patients (all men, mean age 39 years, range 18-70) treated between 1989 and 1999 for strictures 5-30 mm long. Forty-one of the patients (55%) had been treated previously, 39 endoscopically (urethrotomy and/or dilatation) and two surgically. Surgical access was perineal, with the patient in an exaggerated lithotomy position; the stenotic segment was excised and the stumps spatulated for end-to-end anastomosis. The mean (range) duration of surgery was 140 (75-280) min. There were no complications during or after surgery, and none related to the duration in the lithotomy position. At a mean follow-up of 60 months, 93% of the patients had no recurrence of the stricture and were therefore considered cured. There were no treatment-related complications. End-to-end anastomosis is confirmed as the treatment of choice for short bulbous urethral strictures, giving cure rates close to 100%.