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Outcome determinants of urethroplasty in the management of inflammatory anterior urethral strictures

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dc.contributor.author Claassen, F.M
dc.contributor.author Mutambirwa, S.B.A
dc.contributor.author Potgieter, L.
dc.contributor.author Botes, L.
dc.contributor.author Kotze, H.F.
dc.contributor.author Smit, F.E.
dc.date.accessioned 2021-01-17T13:35:01Z
dc.date.available 2021-01-17T13:35:01Z
dc.date.issued 2019
dc.identifier.issn 2078-5135
dc.identifier.uri http://hdl.handle.net/11462/2164
dc.description Published Article en_US
dc.description.abstract Background. Limited data are available on outcomes of the surgical management of inflammatory urethral strictures secondary to infection, a major cause of stricture. Several shortcomings that need to be addressed have been identified in the past. Objective. To determine the impact of stricture length, position and degree of obliterative urethral lumen on the surgical outcomes of corrective procedures for inflammatory anterior urethral strictures. Methods. This retrospective analysis used the records of patients who presented with proven infective anterior urethral strictures at an academic hospital from 2007 to 2010. All patients were followed up after 48 months. Urethroplasty outcomes were analysed according to stricture location and length and effect of urethral obliteration. Results. The median age of the 174 patients in the study was 47 (range 21 - 86) years. Anastomotic urethroplasty was successful in 59/99 (59.6%) patients. Augmented anastomotic urethroplasty was successful in 11/15 (73.3%) patients. Dorsal onlay buccal mucosa graft urethroplasty was successful in 23/32 (71.9%) patients, significantly higher than in 2/9 (22.2%) patients who underwent ventral onlay buccal mucosa graft urethroplasty (p=0.017; hazard ratio 3.4; 95% confidence interval 1.29 - 9.40). The one-stage circular pedicled penile skin-flap urethroplasty was successful in 1/12 (8.3%) patients. Two-stage urethroplasty was successful in 5/7 (71.4%) patients. A primary component analysis of the 73 failed procedures showed that stricture length was the main contributor to failure (eigenvalue 1.79; 45%). Conclusions. Urethroplasty remains a challenge in inflammatory urethral strictures, where stricture length was the main reason for treatment failure. en_US
dc.language.iso en en_US
dc.publisher South African Medical Journal en_US
dc.relation.ispartofseries SAMJ;December 2019, Vol. 109, No. 12
dc.title Outcome determinants of urethroplasty in the management of inflammatory anterior urethral strictures en_US
dc.type Article en_US

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