Pericatheter urethrogram after anastomotic urethroplasty: Is it a must?

Area of Science:

• Urology
• Surgical Innovation
• Patient Outcomes

Background:

• Anastomotic urethroplasty is a standard surgical procedure for urethral strictures.
• Post-operative imaging, such as pericatheter urethrogram, is often used to assess healing.
• The necessity and timing of routine post-operative imaging require further investigation.

Purpose of the Study:

• To evaluate the initial experience of performing anastomotic urethroplasty and trial without catheter (TWOC).
• To assess the feasibility and outcomes of omitting routine post-urethroplasty pericatheter urethrogram before catheter removal.

Main Methods:

• A prospective review of 18 patients undergoing standard transecting anastomotic urethroplasty by a single surgeon.
• Suprapubic and urethral catheters were removed at 2 and 4-5 weeks, respectively, followed by TWOC.
• Uroflowmetry (UFM) was performed at regular intervals; ascending urethrogram was reserved for cases with Qmax < 15 ml/s or suspected recurrence.

Main Results:

• The recurrence rate was 16.6% (3/18 patients), with a mean follow-up of 13.8 months.
• Two patients developed infection; no cases of incontinence or impotence were reported.
• The study demonstrated successful TWOC without routine pericatheter urethrogram in most cases.

Conclusions:

• Pericatheter urethrogram is not mandatory for all tension-free anastomotic urethroplasties before catheter removal.
• Omitting routine imaging can reduce infection risk, radiation exposure, and healthcare costs.
• This approach may be considered for routine cases, reserving imaging for complex anastomoses or redo procedures.