Long-term results of end-to-end urethroplasty

We evaluated long term results of end-to-end urethroplasty. We reviewed 40 patients with bulbar urethral stricture of diverse origin: iatrogenic 40%, traumatic 15%, infectious 2% and unknown 40%. In 17 cases internal urethrotomy was made previously. The radiological study with retrograde and voiding cystogram revealed a bulbar location in all cases and a length inferior to 1 cm in 13 cases, between 1-2 cm in 26 cases and 2-3 cm in 1 case. The maximum flow rate varied between 3-13 ml/s. The absence of bacteriuria was valued by means of preoperating culture. The average time of pursuit was 45 months (12-142 months). The stricture was considered resolute when not appear compatible radiological or functional finds of failure. In 37 cases (92%) the results were satisfactory, without secondary surgical procedure. After surgery maximum flow-rate varied between 18-45 ml/s. In two patients with failure, internal urethrotomy was decisive. In this case the stricture origin was traumatic. The third patient with failure was finally chosen to make new end-to-end urethroplasty, with good later result. End-to-end urethroplasty is a highly decisive technique for bulbar urethral stricture. The preoperating diagnosis is based on the radiological study (retrograde and voiding cystogram). The postoperating control must be based on clinic and uroflow study. Traumatic stricture repair showed worse results. In cases of failure, internal urethrotomy allows to complement successful results of end-to-end urethroplasty.