A retrospective analysis of delayed complications of urethroplasty at a tertiary care centre

Abstract

Urethroplasty is commonly performed worldwide by reconstructive urologists and such a large scale practice is often faced with numerous complications, yet "complication based analysis" still persists as a gray area. Our study aims to provide an evaluation of long-term post-urethroplasty complications, after the five commonly practiced procedures, at our centre. 302 male patients with urethral strictures due to various etiologies were assessed preoperatively via retrograde urethrogram, urethrosonogram, and uroflowmetry. They were then subjected to different urethroplasty techniques viz. tunica albuginea urethroplasty (TAU), U-shaped prostato-bulbar anastomosis (USPBA), dorsal buccal mucosa graft urethroplasty, skin substitution urethroplasty and Dartos flap urethroplasty. Postoperatively, patients were assessed at regular intervals, regarding the occurrence of complications. The overall complication rate was 21% at 5 years follow-up, with the majority during the initial 2 years. Infection and restenosis were the major long-term complications (12%). Maximum complications were seen in patients, who underwent TAU and USPBA simultaneously followed by Dartos flap urethroplasty and minimum were seen with TAU. In conclusion, a meticulous post-urethroplasty follow-up reveals a wide range of long-term complications. The complication rate differs in accordance with the etiology, site and length of stricture as well as the reconstructive technique.

Urethral Reconstruction Using Buccal Mucosa or Penile Skin Grafts: Systematic Review and Meta-Analysis

“…Reasons for exclusion were: review with lack of original data (n = 8), lack of personalized data (n = 12), no specification on graft type (n = 2), use of penile flaps instead of grafts (n = 5), mix of penile grafts with flaps (n = 1) and exclusively LS etiology (n = 2). Finally, 18 papers [21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38] were included for evaluation and meta-analysis.…”

The nursing application of multifunctional protective pants after posterior urethral stricture surgery: A randomized clinical trial

“…The treatment of urethral stricture mainly involves open surgery [8][9][10][11] . Currently, there is extensive research on preoperative preparation and intraoperative procedures [12] , while postoperative care and recovery remain relatively understudied [13] . Postoperative care and preoperative preparation, as well as intraoperative procedures, are equally important in the management of urethral strictures and are integral parts of the treatment process [14][15][16][17] .…”

Collagen scaffolds tethered with bFGF promote corpus spongiosum regeneration in a beagle model

“…However, these materials usually do not have sinusoid-like structure similar to the corpus spongiosum and cannot restore the rich vascular supply of the urethra. When these substitutes are used clinically, complications occur frequently and the risk of complications increases with time [20,21].…”