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Proximal Urethrostomy Versus Urethroplasty for Complex Urethral Strictures
Nir J Rahav1, Mohamad Udah2, Sarit Cohen2
1Center for Reconstructive and Functional Urology, Shaare Zedek Medical Center, Jerusalem, Israel.
European Urology Open Science
|March 15, 2024
Summary
Proximal urethrostomy and urethroplasty show similar outcomes for complex urethral stricture (CUS). Both treatments offer comparable results in recurrence rates and patient-reported quality of life.
Area of Science:
- Urology
- Surgical Outcomes
- Reconstructive Surgery
Background:
- Optimal treatment for complex urethral stricture (CUS) remains undetermined.
- Limited comparative data exists for CUS treatment methods using validated outcomes.
Purpose of the Study:
- To compare proximal urethrostomy and urethroplasty for CUS.
- To evaluate outcomes using objective measures and validated questionnaires.
- To analyze trends in patient subgroups.
Main Methods:
- Retrospective analysis of patients with CUS from 2004-2021.
- Comparison between proximal urethrostomy (n=57) and urethroplasty (n=75).
- Primary outcome: stricture recurrence; Secondary outcomes: uroflowmetry, post-void residual, validated questionnaires.
Main Results:
- No significant difference in stricture recurrence (22.6% vs 36.2%, p=0.106).
- Similar postoperative quality of urination, life, satisfaction, and erectile function.
- Both groups showed improved urinary flow; no significant difference in post-void residual.
Conclusions:
- Proximal urethrostomy is an equivalent alternative to urethroplasty for CUS.
- No significant differences in recurrence or patient-reported outcomes were observed.
- Proximal urethrostomy should be considered a viable treatment option for complex urethral stricture.
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