Delayed Single Stage Perineal Posterior Urethroplasty
Shahzad Ali1, Shahnawaz1, Iqbal Shahzad1
1Department of Urology, Jinnah Postgraduate Medical Centre (JPMC), Karachi.
Summary
Delayed single-stage perineal posterior urethroplasty is an effective treatment for posterior urethral strictures. This procedure demonstrated a high success rate, offering good long-term outcomes for patients with urethral defects.
Area of Science:
- Urology
- Surgical Techniques
Background:
- Posterior urethral strictures and distraction defects often result from trauma.
- Management of these conditions can be challenging, requiring effective surgical interventions.
Purpose of the Study:
- To evaluate the efficacy of delayed single-stage perineal posterior urethroplasty.
- To determine the success rates and outcomes of this surgical approach for posterior urethral strictures/distraction defects.
Main Methods:
- A descriptive case series was conducted involving 30 male patients.
- Patients underwent delayed single-stage perineal posterior urethroplasty after initial suprapubic catheterization for at least 3 months.
- Follow-up averaged 10 months.
Main Results:
- The overall success rate was 93.3% with permissive criteria (allowing single direct visual internal urethrotomy) and 76.6% with strict criteria (no further procedures).
- Recurrent strictures occurred in 23.3% of patients, with most successfully managed by single direct visual internal urethrotomy.
- Only 6.6% of patients required re-do perineal urethroplasty.
Conclusions:
- Delayed single-stage perineal posterior urethroplasty is a successful treatment for posterior urethral strictures/distraction defects.
- The procedure offers excellent long-term results, even in patients with a history of multiple prior interventions.
