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Descripción:

Urethral stenosis is a common disease

in the clinical practice of urology, with a major impact

on the quality of life of patients. The anastomotic

urethroplasty is a technique with very precise indications

usually membranous or bulbar urethra stenosis with a

length of 3 cm or up to 7 cm when it is secondary to

urethral disruptions (no stenosis) after pelvic trauma.

OBJECTIVE: We review anastomotic urethroplasty

performed in our department between 2002 and 2015.

METHODS: A retrospective, descriptive and inferential

analysis on 107 patients out of 482 treated with

Anastomotic urethroplasty by urethral strictures at the

Urology Department of the Hospital “Virgen de la Victoria”

(Malaga) from January 2002 to September 2015,

establishing effectiveness and safety of the technique,

as well as factors that might influence the results. The

main diagnostic method was retrograde urethrography

and voiding cystourethrography in 100% of patients

undergoing surgery, using voiding uroflowmetry for

subsequent monitoring. The definition of success was a

postoperative flowmetry with Qmax>15 ml/s, and in

case of lower flow, we perform a cystoscopy to verify

recurrence of stenosis or exclude other pathology.

RESULTS: The median age was 42 years, with a

mean follow up of 59 months. The length of stenosis

valued by retrograde urethrography and voiding

cystourethrography was in 91.6% of cases of >1 cm

and <2 cm. The most common etiology was idiopathic

in 72.9%, followed by iatrogenic with 15.9%.

Regarding the location, it was observed that the area

most often affected was the bulbar urethra with 82.2%,

with the membranous urethra in second place. In 77.6%

of patients anastomotic urethroplasty was the initial

treatment, followed in frequency by direct vision internal

urethrotomy 9.3%.

In the case of comorbidities associated with treatment

with anastomotic urethroplasty it was observed that

only Diabetes Mellitus had a tendency to statistical

significance, with p=0.092, not demonstrating such

significance in the case of hypertension or when the

subject presented Diabetes Mellitus together with

hypertension. Finally, the intervention was successful in

102 cases (95.3%), with only 5 cases (4.7%) where

it failed, 4 of them treated with a new Anastomotic

urethroplasty, with resolution of the stricture.

CONCLUSIONS: Anastomotic urethroplasty is the

treatment of choice for short bulbar urethral stricture, with

high success rate and low complication rate, as well as

low recurrence of these.