Double-face urethroplasty in patients with obliterative bulbar strictures post-transurethral resection of the prostate mid-term outcomes in high-volume referral center

Abstract

Objective: Incidences of post-transurethral resection of the prostate (post-TURP) strictures are between 2.2% and 9.8%. Stricture commonly occurs within the first 6 months. Our objective was to assess the outcomes of patients with obliterative strictures post-TURP that underwent a double-face urethroplasty. Methods: This is a single-center prospective study of 17 patients with obliterative proximal bulbar stricture post-TURP who underwent double-face graft urethroplasty by two surgeons between January 2014 and January 2020. We defined post-TURP obliterative strictures as those patients who presented with complete or almost complete obstruction of the urethral lumen and who have had a history of acute urine retention. We have excluded patients with bladder neck contracture. Primary outcome was treatment success, defined as the no need for further treatments. Secondary outcome was post-urethroplasty continent rate. Results: Seventeen patients were included in the study with median age of 66 (interquartile range 40–77) years; median time of follow-up was 24 (interquartile range 12–84) months; median stricture length was 4 (interquartile range 2–6) cm. Of the 17 patients, 15 (88.2%) were successful. All patients were continent after urethroplasty. Conclusion: With mid-term follow-up, treatment of obliterative proximal bulbar strictures with double-face buccal mucosa graft is a safe and effective procedure. Obliterative proximal bulbar strictures merit double-face urethroplasty with high-rate success and functional outcomes.

Keywords

• Double-face urethroplasty
• Obliterative urethral stricture
• Post-transurethral resection of prostate
• Urethral stricture
• Spongiofibrosis
• Iatrogenic stricture