Urethral Reconstruction in a Reference Center in Eastern Colombia

• Published in: Urologia Colombiana 2020-03, Vol.29 (1), p.026-031
• Main Authors: Tobar-Roa, Verónica, Ortiz-Zableh, Ana María, Mantilla-Rey, Daniel José, Sarmiento-Sarmiento, Guillermo
• Format: Article
• Language: English
• Subjects: Original Article | Artículo Original
• ISSN: 0120-789X; 2027-0119
• DOI: 10.1055/s-0039-1698797

Abstract Introduction and Objectives  Urethral stricture is a complex pathology of multiple etiologies, and of unknown incidence in our country. There are multiple options for the management of urethral stricture, from minimally invasive procedures, like urethral dilation or direct vision internal urethrotomy, to open surgical reconstruction using excision and primary anastomosis (EPA), or augmented urethroplasty with tissue graft. The aim of the present study is to describe the characteristics of the patients managed with urethral reconstructive surgery in a reference center in eastern Colombia. Methods  Observational retrospective cohort study. Data was obtained from patients undergoing urethral reconstructive surgery at the institution from August 2013 to December 2017. All of the surgeries were performed by the same surgical team. The clinical and demographic variables were collected, and the validated urethral stricture surgery patient-reported outcome measure (USS-PROM) questionnaire was applied. Results  A total of 56 patients were included in the study, 26 patients (46.4%) underwent excision and primary anastomosis (EPA), and 30 (53.6%) underwent graft urethroplasty. The average age at the time of the intervention was 53.3 years old. The most frequent etiology was trauma, and the mean length of the stenosis was 1.7 cm for the EPA group, and 3 cm for the graft urethroplasty group ( p  = 0.009). A history of previous surgery was found in 66% of the patients, and radiotherapy in 2 patients. The mean follow-up was of 14 months (range: 0–52 months), observing similar success rates for both techniques. Despite of the small sample size, when analyzing the Kaplan-Meier curves, we observed a tendency of a better response in the group without previous treatments and with stenosis with a length