Urethroplasty for strictures after phallic reconstruction: a single-institution experience
Nicolaas Lumen1, Stan Monstrey, An-Sofie Goessaert
1Department of Urology, Ghent University Hospital, Ghent, Belgium. lumennicolaas@hotmail.com
European Urology
|December 15, 2010
Summary
Urethroplasty for phalloplasty strictures has a high recurrence rate, especially at the anastomosis site. This study evaluates outcomes to guide future treatment recommendations for these challenging urethral strictures.
Area of Science:
- Urology
- Reconstructive Surgery
Background:
- Treatment guidelines for post-phalloplasty urethral strictures are currently insufficient.
- Phalloplasty is a complex procedure with potential complications, including urethral strictures.
Purpose of the Study:
- To assess the outcomes of various urethroplasty techniques for treating urethral strictures following phalloplasty.
- To establish evidence-based recommendations for managing these strictures.
Main Methods:
- A retrospective review of 118 urethroplasties performed in 79 patients with post-phalloplasty strictures.
- Analysis of different surgical techniques including meatotomy, Heineke-Mikulicz principle (HMP), excision and primary anastomosis (EPA), free graft urethroplasty (FGU), pedicled flap urethroplasty (PFU), two-stage urethroplasty (TSU), and perineostomy followed by urethral reconstruction (PUR).
- Recurrence was defined as the need for further intervention.
Main Results:
- The mean stricture length was 3.6 cm, with the most common location being the anastomosis (48 urethroplasties).
- Overall stricture recurrence was 41.12% across all techniques.
- Recurrence rates varied by technique, ranging from 25% for meatotomy to 61.9% for PUR.
Conclusions:
- Urethroplasty for post-phalloplasty strictures is associated with a significant recurrence rate.
- The anastomosis site is the most frequent location for strictures after phalloplasty.
- Further research and standardized treatment protocols are needed to improve outcomes.
