Penile urethral stricture disease not associated with hypospadias is rare, and there is a wide range of commonly used surgical repair techniques for this disease. We sought to compile a multi-institutional database of patients who had surgical correction of strictures in the penile urethra not limited to the meatus, and who had no history of hypospadias, for analysis using the Trauma and Urologic Reconstructive Network of Surgeons length, urethral segment and etiology classification system.
A retrospective database from 13 institutions was compiled of patients who had undergone surgical correction of Trauma and Urologic Reconstructive Network of Surgeons length, urethral segment and etiology urethral stricture segments S2b/S2c and excluding E5, with a minimum follow-up time of 4 months. Failure was defined as cystoscopically confirmed recurrence of a stricture measuring less than 16-Fr.
We analyzed 222 patients with a median age of 57 years and a follow-up of 49 months. The overall surgical success rate was 80.2%. On multivariate analysis, the two variables identified that were predictive of surgical success were stricture length ≤2 cm as well as use of a buccal mucosa graft as compared to use of a fasciocutaneous flap, which had success rates of 83% and 52%, respectively (P = 0.0004). No statistically significant differences were found based on incisional approach or surgical technique, nor were outcomes different based on etiology or preoperative patient demographics.
Surgical repair of penile urethral strictures of non-hypospadiac origin have a favorable overall success rate, at 80.2%. Regardless of incisional approach or surgical technique, all operations appear to have similar outcomes other than repairs using fasciocutaneous flap, which were statistically less successful than those using buccal mucosa graft.
International journal of urology : official journal of the Japanese Urological Association. 2022 Feb 03 [Epub ahead of print]
David Abramowitz, Andre-Philippe Sam, Mark Pachorek, Nora Ruel, Francisco Martins, Javier Angulo, Jay Simhan, Eric Li, Dmitriy Nikolavsky, Connor Policastro, Erick Ramirez-Perez, Frank Burks, Zubin Shetty, Krishnan Venkatesan, Craig Hunter, Maxx Gallegos, Jordan Foreman, Joseph Pariser, Khushabu Kasabwala, Damian Lopez, Susan Macdonald, Jonathan Warner
University at Buffalo, Buffalo, NY, USA., University of California at Riverside, Riverside, CA, USA., Pasadena City College, Pasadena, CA, USA., Department of Biostatistics, City of Hope Medical Center, Duarte, CA, USA., University of Lisbon Medical Faculty, Lisbon, Portugal., Universidad Europea: Universidad Europea de Madrid SLU, Madrid, Spain., Albert Einstein Healthcare Network, Philadelphia, PA, USA., State University of New York Upstate Medical University, Syracuse, NY, USA., Hospital Angeles Mocel, Mexico City, Mexico., Beaumont Health, Royal Oak, MI, USA., MedStar Health, Washington, DC, USA., Urology Specialists of Nevada, Las Vegas, NV, USA., University of New Mexico Health Sciences Center, Santa Fe, NM, USA., University of Minnesota Health, Minneapolis, MN, USA., Hospital Regional Licenciado Adolfo Lopez Mateos, Mexico City, Mexico., Penn State Health Milton S Hershey Medical Center, Hershey, PA, USA., Mayo Clinic, Rochester, MN, USA.