[Two-stage surgical treatment of urethral stenosis]

We analysed the results of two-operation procedures for cutaneous urethroplasty performed over a 10 year period. From 1983 to 1993, 44 patients had a Leadbetter urethroplasty. The indication in all cases was stenosis of the bulbal or bulbomenbranous urethra complicated by urethro-cutaneous fistula. After the first operation, 10 patients (22.7%) had a stenosis of one or both of the urethrostomy orifices, requiring one or more further procedures. The second operation concerned 18 patients (40.9%) and gave goods results in 10 (55.5%). Poor results were due to recurrence of the stenosis in 3 cases (16.6%), perineal suppuration in 1 (5.5%), failure of the skin plasty in 1 (5.5%) and formation of a stenosis by a tuft of hair in 1 (5.5%). Finally, 2 patients were lost to follow-up. Mean interval between operations was 8 months. It appears, despite the drawbacks and uncertain results, that sequential operations for cutaneous urethroplasty are indicated when stenosis of the urethra is complicated by fistulization or perineal infection.