Mp32-01 Functional and Patient Reported Outcomes in Non-Transecting Excision-Anastomosis Urethroplasty for Lengthy (≥2cm) Urethral Strictures

You have accessJournal of UrologyReconstruction: Urethral Reconstruction (Including Stricture) II (MP32)1 May 2024MP32-01 FUNCTIONAL AND PATIENT REPORTED OUTCOMES IN NON-TRANSECTING EXCISION-ANASTOMOSIS URETHROPLASTY FOR LENGTHY (≥2CM) URETHRAL STRICTURES Alexandr M. Pinkhasov, Anthony E. Fadel, Katherine T. Anderson, and Boyd R. Viers Alexandr M. PinkhasovAlexandr M. Pinkhasov , Anthony E. FadelAnthony E. Fadel , Katherine T. AndersonKatherine T. Anderson , and Boyd R. ViersBoyd R. Viers View All Author Informationhttps://doi.org/10.1097/01.JU.0001008816.80828.35.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: For lengthy bulbar strictures (≥2cm), many advocate for oral mucosa substitution urethroplasty due to the concern of penile shortening or other erectile function related side effects. Although effective, substitution bulbar urethroplasty is associated with graft harvest morbidity and may have lower success rates relative to non-substitution non-transecting techniques. We describe outcomes of an extended non-transecting excision-anastomosis urethroplasty for lengthy urethral strictures without the use of graft augmentation. METHODS: A tertiary center's urethroplasty database was queried for patients that underwent non-transecting bulbar urethroplasty from 2017-2023. Stretch penile length (SPL) was assessed pre- and post- operatively and at 3-6 months follow-up. Urethral stricture recurrence was defined as the need for repeat intervention. A survey comprised of urethral stricture surgery patient reported outcome measure (USS-PROM), urinary symptom interference (USI), penile complications (PC), international index of erectile function (IIEF-5) and overall patient satisfaction (OPS) was collected(N=39). Association between groups was assessed with Fischer's exact test and Mann Whitney U test. RESULTS: A final cohort of 90 patients with a median urethral stricture length of 1.5cm (range 0.5-6cm) were identified. When stratified by stricture length ≥2cm (N=41) and 0.05). When assessing for PC, there was no significant difference in patient perceived glans firmness, angulation, ejaculation, sensation, or penile length (all p>0.05). When erectile function was assessed with IIEF-5, there was no significant difference in total score between groups (23 vs 23, p=0.83). USS-PROM (12 vs 8) and USI (1 vs. 2) was not significantly different between groups (p=0.08 and p=0.09, respectively). OPS was higher in patients with shorter repairs (median 4 vs 3, p=.03). CONCLUSIONS: Spongiosal sparing non-transecting urethroplasty is an effective surgical option for patients with lengthy urethral strictures. It offers comparable improvement in functional outcomes including Qmax, PVR, stricture recurrence, as well as subjective patient reported outcomes all while avoiding the morbidity of graft harvesting. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e514 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Alexandr M. Pinkhasov More articles by this author Anthony E. Fadel More articles by this author Katherine T. Anderson More articles by this author Boyd R. Viers More articles by this author Expand All Advertisement PDF downloadLoading ...