OBJECTIVE: • Urethral strictures located in the fossa navicularis are common and are often managed with meatotomy or meatoplasty. • Few data have described the outcomes for men after urethroplasty or patient satisfaction following these procedures. METHODS: • In all, 93 men at two different institutions underwent surgical repair of distal urethral stricture disease using meatotomy (73) or meatoplasty (20), with 13/20 (65%) of the latter group undergoing substitution urethroplasty. • In patients with lichen sclerosus (LS), all involved tissue was excised prior to reconstruction. • In a subset of men undergoing meatotomy, patient satisfaction was evaluated by questionnaire. RESULTS: • Average clinical follow-up for men undergoing distal urethroplasty was 61 months. • Successful reconstruction requiring no further intervention occurred in 84% of men overall. Subgroup analysis revealed success in 87% of men with meatotomy, 75% with meatoplasty and 66% with substitution urethroplasty. • Men with LS had a significantly greater rate of stricture recurrence (20.5% vs 7.5%, P= 0.04). • Of the subset of men who completed a patient-based questionnaire 84% reported they were either satisfied or very satisfied with the results of their meatotomy. CONCLUSIONS: • We report the success of distal urethral stricture management. • Meatal strictures may be approached successfully in a stepwise manner progressing from meatotomy to meatoplasty for longer recurrent strictures, with a high overall success rate for meatotomy. • Although substitution grafts may be useful for men with longer distal strictures and those with LS, the risk of recurrence was significantly higher in this cohort.
OBJECTIVE: • Urethral strictures located in the fossa navicularis are common and are often managed with meatotomy or meatoplasty. • Few data have described the outcomes for men after urethroplasty or patient satisfaction following these procedures. METHODS: • In all, 93 men at two different institutions underwent surgical repair of distal urethral stricture disease using meatotomy (73) or meatoplasty (20), with 13/20 (65%) of the latter group undergoing substitution urethroplasty. • In patients with lichen sclerosus (LS), all involved tissue was excised prior to reconstruction. • In a subset of men undergoing meatotomy, patient satisfaction was evaluated by questionnaire. RESULTS: • Average clinical follow-up for men undergoing distal urethroplasty was 61 months. • Successful reconstruction requiring no further intervention occurred in 84% of men overall. Subgroup analysis revealed success in 87% of men with meatotomy, 75% with meatoplasty and 66% with substitution urethroplasty. • Men with LS had a significantly greater rate of stricture recurrence (20.5% vs 7.5%, P= 0.04). • Of the subset of men who completed a patient-based questionnaire 84% reported they were either satisfied or very satisfied with the results of their meatotomy. CONCLUSIONS: • We report the success of distal urethral stricture management. • Meatal strictures may be approached successfully in a stepwise manner progressing from meatotomy to meatoplasty for longer recurrent strictures, with a high overall success rate for meatotomy. • Although substitution grafts may be useful for men with longer distal strictures and those with LS, the risk of recurrence was significantly higher in this cohort.
Authors: Michael Daneshvar; Jay Simhan; Stephen Blakely; Javier C Angulo; Jacob Lucas; Craig Hunter; Justin Chee; Damian Lopez Alvarado; Erick Alejandro Ramirez Perez; Alosh Madala; Juan José de Benito; Francisco Martins; João Felício; Paul Rusilko; Brian J Flynn; Dmitriy Nikolavsky Journal: World J Urol Date: 2020-01-01 Impact factor: 4.226
Authors: Marco Bandini; Guido Barbagli; Riccardo Leni; Giuseppe O Cirulli; Giuseppe Basile; Sofia Balò; Francesco Montorsi; Salvatore Sansalone; Andrea Salonia; Alberto Briganti; Denis Butnaru; Massimo Lazzeri Journal: World J Urol Date: 2021-04-15 Impact factor: 4.226