Urethroplasty for anterior urethral strictures in a community-based urology practice

The outcome of urethroplasty for the anterior urethral stricture is superior to internal urethrotomy. However, the excellent results are often reported by tertiary medical centres and most urologists in general urological practice do not offer urethroplasty. We review the results of our institution to ascertain whether equivalent results are achievable in a district hospital urology service.

Over a 22-month period, 26 urethroplasties were performed. Mean age was 44.2 years (range: 16-83 years) and median follow-up was 14.6 months (range: 0.6-40.2 months). Anastomotic repair was performed in five, substitution urethroplasty in 15 (nine flaps and six grafts) and staged urethroplasty in 6. Length of strictures ranged from less than 0.2 cm to greater than 10 cm.

Stricture-free rate of 90.5% at 1 year was observed. Only two cases developed repeat stricture formation. Other minor complications included one epididymo-orchitis and one haematoma.

Good early outcome for urethroplasty for anterior urethral strictures is achievable in a district hospital practice. Keys to good outcome include having a dedicated team and a wide repertoire of urethral reconstructive techniques.