Short-term outcomes of urethroplasty: experience from a specialized center: a retrospective descriptive cohort study

Abstract

Objectives: To assess the outcome of urethroplasty, the rate of recurrence, and post-operative complications in a high-volume tertiary care centre.

Method: The retrospective, descriptive study was conducted at the Pakistan Kidney and Liver Institute and Research Centre, Lahore, Pakistan, and comprised data of male patients who had urethroplasty because of urethral stricture disease between September 2018 and September 2024. Demographics, clinical and surgical history as well as outcomes were noted. Data was analysed using SPSS 27.

Results: Of the 22 male patients with mean age 35.2 ± 11.5 years and mean body mass index 24.84 ± 4.60kg/m², 16(72.7%) had urethral strictures that were traumatic, 12(54.5%) had anterior strictures and 10(45.5%) had posterior strictures. Anastomotic urethroplasty was performed in 10(45.5%) cases and buccal mucosal graft replacement in 9(40.9%). The mean surgical time was 163.87 ± 48.16 minutes. There was 1(4.5%) case of recurrence. Two (9.1%) patients had bleeding and 5(22.7%) had fever as immediate post-surgery complication. Six (27.3%) reported experiencing painful ejaculation, while 17(77.3%) were able to void normally. The median blood loss was 50mL (interquartile range: 20-130mL), and the median hospital stay was 2 days (interquartile range: 1-3 days). All 22(100%) patients had erectile dysfunction prior to surgery, and 2(9.1%) exhibited improvement post-surgery. As part of 30-day complications, recurrent constriction occurred in 2(9.1%) patients and urinary tract infection in 2(9.1%).

Conclusion: Urethral strictures could be effectively treated by urethroplasty. However, even with positive urine results, erectile dysfunction is a problem that needs more research.

Key Words: Kulkarni technique, Buccal mucosal graft, Urethroplasty, Urethral stricture, Surgical results, Complications.