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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
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.
Sobre el editor:
Revista Internacional de Urología indexada y peer-reviewed, fundada en 1944, dirigida a toda la comunidad científica. Aquí encontrarás las últimas novedades y hallazgos urológicos. Publicamos 10 números anuales.