Post-Urethroplasty Outcomes in Malaysia: A Tertiary Referral Center Long-Term Experience

Background: Urethral stricture disease involves fibrotic narrowing of the urethra, leading to obstructive urinary symptoms. Urethroplasty, including EPA and BMG techniques, offers high success rates, yet recurrence and other complications remain a concern. This study aims to assess stricture recurrence and other outcomes in a Malaysian tertiary center and identify associated risk factors to improve future treatment strategies. Objective: To evaluate stricture-free survival, identify recurrence risk factors, and analyze postoperative complications following urethroplasty at Hospital Serdang. Methods: A retrospective review of 76 patients who underwent urethroplasty from 2019 to 2024 at Hospital Sultan Idris Shah Serdang was performed. Patients were categorized based on surgery type: excision and primary anastomosis (EPA) or buccal mucosa graft (BMG) augmentation. Data on demographics, stricture characteristics, surgical details, and outcomes were analyzed. Results: 85% of the patients were stricture-free for 5 years. Mean postoperative uroflow was 11.61 ml/s. Postoperatively, 14 (18.2%) had erectile dysfunction, 4 (5.2%) hematoma, and 1 (1.3%) surgical site infection. 12 cases (15.6%) had restricture. The majority of these cases underwent serial dilatation (83.3%), and 2 of these cases underwent revision urethroplasty (16.7%). Conclusion: Urethroplasty is feasible for a wide range of urethral stricture cases, with great outcomes and minimal complications. Diabetics have an increased risk of stricture recurrence postoperatively (odds ratio 3.6).