Skip to main content

Advertisement

Log in

Redo-urethroplasty: comparison of early functional results and quality of life in penile and bulbar strictures

  • Original Article
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To assess bothersome results of surgery and changes in quality of life (QoL) in patients with redo-urethroplasty, comparing the functional results of penile and bulbar cases. As after previous urethroplasty scar tissue formation is likely to occur, less favorable functional results than at primary repair could be expected. Yet data on these items for techniques currently used are limited.

Methods

Retrospective analysis with standardized questionnaire including 33 consecutive patients treated with redo-urethroplasty for bulbar or penile strictures. Previous surgeries, recurrence rate, complications, incontinence, erectile function, satisfaction with the surgery and QoL were assessed.

Results

Overall success rate was 78.8 %, number of previous open urethroplasty once in 24 patients (72.7 %), and more than once in 9 (27.3 %). Urinary stress incontinence Grade I occurred in 5 patients (15.2 %) and Grade II in 2 patients (6.1 %). In 24 patients (72.7 %), no penile shortening occurred and in 28 (84.8 %), no deviation was observed. Eight patients (24.2 %) reported their glans sensitivity to be altered, in 3 (9.1 %) a disturbing alteration occurred. Overall satisfaction with the surgery was high (70 %), and an improvement in QoL was seen in 72.7 % (24 patients).

Conclusions

Urethroplasty after failed open repair gives good functional results and shows a high patient satisfaction rate. However, results are not quite as good as for primary repair, emphasizing the importance of a successful primary repair.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Barbagli G, De Angelis M, Romano G, Lazzeri M (2007) Long-term followup of bulbar end-to-end anastomosis: a retrospective analysis of 153 patients in a single center experience. J Urol 178(6):2470–2473. doi:10.1016/j.juro.2007.08.018

    Article  PubMed  Google Scholar 

  2. Eltahawy EA, Virasoro R, Schlossberg SM, McCammon KA, Jordan GH (2007) Long-term followup for excision and primary anastomosis for anterior urethral strictures. J Urol 177(5):1803–1806. doi:10.1016/j.juro.2007.01.033

    Article  PubMed  Google Scholar 

  3. Morey AF, McAninch JW (1996) When and how to use buccal mucosal grafts in adult bulbar urethroplasty. Urology 48(2):194–198. doi:10.1016/S0090-4295(96)00154-9

    Article  PubMed  CAS  Google Scholar 

  4. Pansadoro V, Emiliozzi P, Gaffi M, Scarpone P (1999) Buccal mucosa urethroplasty for the treatment of bulbar urethral strictures. J Urol 161(5):1501–1503

    Google Scholar 

  5. Hosseini J, Kaviani A, Hosseini M, Mazloomfard MM, Razi A (2011) Dorsal versus ventral oral mucosal graft urethroplasty. Urol J 8(1):48–53.

    Google Scholar 

  6. Jackson MJ, Sciberras J, Mangera A, Brett A, Watkin N, N’Dow JM, Chapple CR, Andrich DE, Pickard RS, Mundy AR (2011) Defining a patient-reported outcome measure for urethral stricture surgery. Eur Urol 60(1):60–68. doi:10.1016/j.eururo.2011.03.003

    Article  PubMed  Google Scholar 

  7. Donovan JL, Abrams P, Peters TJ, Kay HE, Reynard J, Chapple C, De La Rosette JJ, Kondo A (1996) The ICS-’BPH’ Study: the psychometric validity and reliability of the ICSmale questionnaire. Br J Urol 77(4):554–562

    Article  PubMed  CAS  Google Scholar 

  8. Donovan JL, Peters TJ, Abrams P, Brookes ST, de aa Rosette JJ, Schafer W (2000) Scoring the short form ICSmaleSF questionnaire. International Continence Society. J Urol 164(6):1948–1955

    Article  PubMed  CAS  Google Scholar 

  9. The EuroQol Group (1990) EuroQol-a new facility for the measurement of health-related quality of life. Health Policy 16(3):199–208

    Article  Google Scholar 

  10. Peeling WB (1989) Diagnostic assessment of benign prostatic hyperplasia. Prostate Suppl 2:51–68

    Article  PubMed  CAS  Google Scholar 

  11. Fransis K, Vander Eeckt K, Van Poppel H, Joniau S (2010) Results of buccal mucosa grafts for repairing long bulbar urethral strictures. BJU Int 105(8):1170–1172. doi:10.1111/j.1464-410X.2009.08848.x

    Article  PubMed  Google Scholar 

  12. Erickson BA, Granieri MA, Meeks JJ, McVary KT, Gonzalez CM (2010) Prospective analysis of ejaculatory function after anterior urethral reconstruction. J Urol 184(1):238–242. doi:10.1016/j.juro.2010.03.038

    Article  PubMed  Google Scholar 

  13. Johnson EK, Latini JM (2011) The impact of urethroplasty on voiding symptoms and sexual function. Urology 78(1):198–201. doi:10.1016/j.urology.2011.01.045

    Article  PubMed  Google Scholar 

  14. Pansadoro V, Emiliozzi P, Gaffi M, Scarpone P, DePaula F, Pizzo M (2003) Buccal mucosa urethroplasty in the treatment of bulbar urethral strictures. Urology 61(5):1008–1010

    Google Scholar 

  15. Blaschko SD, McAninch JW, Myers JB, Schlomer BJ, Breyer BN (2012) Repeat urethroplasty after failed urethral reconstruction: outcome analysis of 130 patients. J Urol 188(6):2260–2264. doi:10.1016/j.juro.2012.07.101

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Daniel Pfalzgraf.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pfalzgraf, D., Kluth, L., Reiss, P. et al. Redo-urethroplasty: comparison of early functional results and quality of life in penile and bulbar strictures. World J Urol 32, 1191–1197 (2014). https://doi.org/10.1007/s00345-013-1182-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-013-1182-4

Keywords

Navigation