End-to-End Anastomotic Urethroplasty Outcome in Anterior and Posterior Traumatic Urethral Stricture: A Single-Center Experience

Abstract

Introduction The objective of this study was to describe the results and associated factors of anterior and posterior traumatic urethral stricture after end-to-end anastomotic urethroplasty. Methods Medical records were used to retrieve clinical data. We included men over 18 years old who had a traumatic urethral stricture and were treated with end-to-end anastomotic urethroplasty. The data collection period was from January 2015 to December 2021, with at least 12 months follow-up period. After data screening, the data were divided into anterior and posterior strictures. Results Fifty patients were included in the study. The overall mean age was 42.06 (SD 12.4; 95% CI) years old, with a 21 (12-77) month median follow-up. %). The overall restricture rate was 36%. Furthermore, restricture rate in anterior stricture was 21.1%, while in posterior stricture was 45.2%. A significant association with restricture rate was found in the BMI category (p = 0.041) and etiology (p=0.03). There were 19 patients with anterior strictures and 31 patients with posterior strictures. Straddle injury was the most prevalent cause of anterior strictures (63.2%), whereas pelvic injury was the most common cause of posterior strictures (80.6%). For anterior and posterior groups, the majority of patients were normoweight (78.9% & 61.3%), entirely obliterated (63.2% & 64.5%), primary cases (84.2% & 80.6%), and done by reconstructive consultants (84.2% & 80.6%). Conclusion One-third of the patients experienced restricture arter end-to-end anastomotic urethroplasty, a higher restricture rate was found in posterior stricture. Restricture rate was associated with body mass index (BMI) and etiologies. End-to-end anastomotic urethroplasty may give durable patency if appropriately performed, especially in partial anterior traumatic urethral strictures.