Journal of Aesthetic & Reconstructive Surgery

Retrospective Analysis of the Results of Surgical Treatment of Patients with Long Strictures and Obliterations of the Urethra

From 2010 till 2019 we operated 147 patients were identified with relapsed UO in bulbous/membranous/prostatic segments of urethra. There were performed: 1) Dorso-ventral buccal mucosa graft augmentation urethroplasty (BMG-AU) and replacement buccal plastic of the urethra – in 73/147 (49.7%), group 1; 2) prepuce-fascio-cutaneous flap-AU (PFCF-AU) – in 12/147 (8.2%), group 2; 3) resection of UO and urethra-vesical anastomosis (RUVA) – in 65/147 (44.2%), group 3. In last group the length of UO was <2 cm. The causes of UO were distracting post-traumatic urethral defect in 80 (54.4%) patients and post-operative UO – in 32 (21.8%): transvesical adenomectomy – in 6 (4.1%), open retropubic radical prostatectomy – in 2 (1.4%), retropubic adenomectomy – in 5 (3.4%), and transurethral resection of the prostate – Ñ?n 13 (8,8%). Post-inflammatory strictures of the urethra were observed in 24 (16,3%) patients. Urethral strictures caused by congenital anomalies amounted to 12 (8,2%) cases. In the history of these patients several surgeries for hypospadias. Catheterization time was <20 days – in 98 (66.7%) and >21 days – in 49 (33.3%). The mean length of postoperative hospitalization (LOH) was 9.2 (SD=1.5) days in 1st, 2nd groups and 12.4 (SD=3.5) days in 3rd group. In the early postoperative period, complications of the second degree according to Clavien were noted: acute urinary retention (ACS) - seven (4.8%) observations, orchoepididymitis - 12 (8.2%), perineal occlusion - 3 (2.0%). In the late postoperative period, complications of three types were observed: Clavien II, IIIb, IV. The effectiveness of different types of urethroplasty ranged from 63,2% to 72,7%.

Author(s):

Sergey Shamrayev

Abstract | Full-Text | PDF

Share this