Modified urethral pull-through operation for posterior urethral stricture and long-term outcome

Area of Science:

• Urology
• Surgical Techniques

Background:

• Posttraumatic posterior urethral stricture is a challenging condition often resulting from pelvic fractures.
• Previous management attempts, including urethroplasty, may fail, necessitating alternative surgical approaches.

Purpose of the Study:

• To evaluate the experience, technique, and long-term outcomes of the modified urethral pull-through operation for posttraumatic posterior urethral stricture.
• To assess the efficacy and safety of this surgical approach in a cohort of patients.

Main Methods:

• A modified urethral pull-through operation was performed on 113 patients with posttraumatic posterior urethral stricture between 1999 and 2007.
• Patients were followed for symptom evaluation, urinary flow rates, and urethrography/urethroscopy as needed.
• Success was defined as requiring no further postoperative procedures.

Main Results:

• A high success rate of 96.5% was achieved, with a final success rate of 100% after managing failures.
• The majority of patients (109) remained symptom-free with improved maximal flow rates (>15 ml/sec).
• Low complication rates were observed, including 3.7% incidence of postoperative erectile dysfunction, with no chordee or penile shortening.

Conclusions:

• The modified urethral pull-through operation is a highly effective and durable treatment for posttraumatic posterior urethral stricture.
• The procedure is associated with a high success rate, minimal complications, and is particularly suitable for patients with prior failed treatments.
• This technique offers a reliable surgical solution for complex urethral strictures.