Introduction and Objectives
We present technique and long-term results of the urethral pull-through operation for posttraumatic posterior urethral stricture.
Material and Methods
A total of 73 patients with posterior urethral stricture resulting from pelvic fracture injury underwent the urethral pull-through operation at our institute from August 1989 to March 2009. Patient age was 6 to 75 years (mean 31.2). Stricture length was 1.5 to 3.2 cm (mean 2.1). In 36 patients (49.3%) previous management with open or endoscopic procedures had failed. Follow-up included symptomatic and urinary flow rate evaluation, which was performed 6 and 12 months after the urethral pull-through operation in all patients and thereafter when needed, and urethrography and/or urethroscopy in patients with voiding symptoms.
Results
Patients were followed for 12 to 120 months (mean 62.5). During that period 58 patients were symptom-free and required no further procedures. The maximal flow rate in each case was greater than 12 ml per second. Recurrent stricture developed in 15 patients. All treatment failures occurred within the first 6 months postoperatively. Failed repairs were successfully managed by endoscopically in 10 patients and by open reconstruction in 5 patients a primary success rate of 96.5% and a final success rate of 100%. All patients were continent. Erectile dysfunction was noted postoperatively in 7 patients (9.5%). There was no chordee, penile shortening or urethral diverticula.
Conclusions
The urethral pull-through operation is effective for the surgical treatment of posterior urethral stricture even after multiple prior procedures.
Article info
Identification
Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
