Qazi Fasihudin, Shahzad Ali, Naresh Kumar.
Improvising our technique of end to end urethroplasty.
J Surg Pak Jan ;14(3):124-7.

Objective: To assess the outcome of improvised technique of urethroplasty. Study design Descriptive study. Place & duration of study: Department of Urology, Jinnah Postgraduate Medical Center Karachi, from 2004 to 2008. Patients and Methods All patients undergoing posterior urethroplasty were included. One stage transperineal urethroplasty was done in all cases. All patients underwent simultaneous antegrade and retrograde urethrogram and endo-evaluation, before definitive surgery, to assess magnitude of urethral separation and bladder neck competence. Success was defined as no or mild / moderate recurrence following definitive urethoplasty, managed successfully with single to thrice internal urethroplasty procedures respectively. Results: Thirty two patients were included in the study. Mean age of the patients was 35 years. In all cases, delayed end to end urethroplasty was performed. These cases remained under follow up. All patients had history of trauma. Twenty two patients suffered road traffic accident and 10 patients had history of fall and sustained trauma to perineum or urethra. Fifteen patients had associated pelvic fracture. One patient developed epididymo-orchitis postoperatively and managed conservatively. Three patients had erectile dysfunction which persisted. One patient developed erectile dysfunction after surgery. All patients remained continent at follow up. Average interval between initial injury and urethroplasty was five months. Post operatively pericatheter urethrogram was done after 03-04 weeks and Foley catheter removed. Fifteen patients (46.8%) required no further treatment after catheter removal. Eight patients (25%) needed single internal urethrotomy within 4-8 weeks of Foley catheter removal. Six patients (18.7%) underwent internal urethrotomy twice in 4-8 weeks of catheter removal. They were kept on clean intermittent self catheterization for few months. Three patients (12.7%) had frequent multiple internal urethrotomy sessions considered as complete failure, and they were planned for re do urethroplasty. Conclusion: Anastomotic urethroplasty offers good long term Results: to patients with posterior urethral trauma and stricture disease.

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