Format

Send to

Choose Destination
Urology. 2015 Apr;85(4):942-7. doi: 10.1016/j.urology.2015.01.013.

Two-sided dorsal plus ventral oral graft bulbar urethroplasty: long-term results and predictive factors.

Author information

1
Center for Urethral and Genitalia Reconstructive Surgery, Arezzo, Italy. Electronic address: enzo.palminteri@inwind.it.
2
Department of Urology, Ghent University Hospital, Ghent, Belgium.
3
Center for Urethral and Genitalia Reconstructive Surgery, Arezzo, Italy.
4
Department of Obstetrics, Gynecology and Urology, 'Sapienza' University, Rome, Italy.
5
Department of Urology, Clinica Cellini, Humanitas Institute, Torino, Italy.
6
Centro Chirurgico Toscano, Arezzo, Italy.
7
Department of Urology, Ospedale Sant'Andrea, 'Sapienza' University, Rome, Italy.

Abstract

OBJECTIVE:

To evaluate long-term outcomes of the 2-sided dorsal plus ventral oral graft (DVOG) urethroplasty by preserving the narrow urethral plate in tight bulbar strictures and investigate which factors might influence long-term outcomes.

METHODS:

This is a single-center retrospective study of 166 patients who underwent DVOG urethroplasty for tight bulbar strictures by a single surgeon (E.P.) between 2002 and 2013. The strictured urethra was opened ventrally; the exposed urethral plate was incised in the midline and augmented dorsally and ventrally using 2 oral grafts. Outcome was considered a failure when any postoperative instrumentation was needed. According to stricture length, patients were classified in 3 groups as follows: ≤1.5 cm (group 1), >1.5 and ≤3.9 cm (group 2), and ≥4 cm (group 3). Time to failure was analyzed using Kaplan-Meier estimates and Cox regression.

RESULTS:

Median follow-up was 47 months (interquartile range, 33-95.5 months). Of the 166 patients, 149 (89.8%) were successful and 17 (10.2%) were failures. Most of the failures (90%) were observed during the first 5 years of follow-up; afterward, the success rate remained stable. The stricture length was a significant predictor of surgical outcome (odds ratio, 1.743 per cm; confidence interval, 1.2-2.5; P <.001); patients with a urethral stricture ≥4 cm presented a higher risk of late failure. Age, stricture etiology, and previous treatment were not significant predictors of surgical outcome.

CONCLUSION:

With long-term follow-up, the treatment of tight bulbar strictures using a 2-sided DVOG urethroplasty showed a high success rate. The stricture length is an independent predictor of failure.

PMID:
25817122
DOI:
10.1016/j.urology.2015.01.013
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center