Multi-institutional review of non-hypospadiac penile urethral stricture management and outcomes

David Abramowitz, Andre Philippe Sam, Mark Pachorek, Nora Ruel, Francisco Martins, Javier Angulo, Jay Simhan, Eric Li, Dmitriy Nikolavsky, Connor Policastro, Erick Ramirez-Perez, Frank Burks, Zubin Shetty, Krishnan Venkatesan, Craig Hunter, Maxx Gallegos, Jordan Foreman, Joseph Pariser, Khushabu Kasabwala, Damian LopezSusan Macdonald, Jonathan Warner

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objectives: Penile urethral stricture disease not associated with hypospadias is rare, and there is a wide range of commonly used surgical repair techniques for this disease. We sought to compile a multi-institutional database of patients who had surgical correction of strictures in the penile urethra not limited to the meatus, and who had no history of hypospadias, for analysis using the Trauma and Urologic Reconstructive Network of Surgeons length, urethral segment and etiology classification system. Methods: A retrospective database from 13 institutions was compiled of patients who had undergone surgical correction of Trauma and Urologic Reconstructive Network of Surgeons length, urethral segment and etiology urethral stricture segments S2b/S2c and excluding E5, with a minimum follow-up time of 4 months. Failure was defined as cystoscopically confirmed recurrence of a stricture measuring less than 16-Fr. Results: We analyzed 222 patients with a median age of 57 years and a follow-up of 49 months. The overall surgical success rate was 80.2%. On multivariate analysis, the two variables identified that were predictive of surgical success were stricture length ≤2 cm as well as use of a buccal mucosa graft as compared to use of a fasciocutaneous flap, which had success rates of 83% and 52%, respectively (P = 0.0004). No statistically significant differences were found based on incisional approach or surgical technique, nor were outcomes different based on etiology or preoperative patient demographics. Conclusions: Surgical repair of penile urethral strictures of non-hypospadiac origin have a favorable overall success rate, at 80.2%. Regardless of incisional approach or surgical technique, all operations appear to have similar outcomes other than repairs using fasciocutaneous flap, which were statistically less successful than those using buccal mucosa graft.

Original languageEnglish (US)
Pages (from-to)376-382
Number of pages7
JournalInternational Journal of Urology
Volume29
Issue number5
DOIs
StatePublished - May 2022

Bibliographical note

Publisher Copyright:
© 2022 The Japanese Urological Association

Keywords

  • Constriction, Pathologic/etiology
  • Female
  • Humans
  • Hypospadias/complications
  • Male
  • Middle Aged
  • Penis/surgery
  • Retrospective Studies
  • Urethral Stricture/etiology

PubMed: MeSH publication types

  • Multicenter Study
  • Journal Article

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