Urethroplasty rarely offered for anterior urethral stricture

Irvine, CA-Most men with anterior urethral strictures are treated without imaging, and 90% are not being offered urethroplasty.

Video: Excision and primary anastomosis anterior urethroplasty

This despite the recommendation by the Société Internationale d’Urologie (SIU)/International Consultation on Urological Diseases (ICUD) that urethral reconstruction be considered a primary management option for men with bulbar urethral strictures, and also for strictures that are recurrent or refractory to a second internal urethrotomy (IU)/dilation.

The findings come from Joel Gelman, MD, director of the Center for Reconstructive Urology at the University of California, Irvine. The prospective data collection of men who were previously evaluated and/or treated for anterior urethral stricture were presented by Justin J. De Grado, MD, MS, fellow in male reconstructive urology at UC Irvine, at the 2015 AUA annual meeting in New Orleans.

With success rates up to 98% reported for urethroplasty in men with anterior urethral strictures, “it’s surprising that 90% of men are never offered urethroplasty to begin with,” Dr. De Grado said.

Data collected on 103 adult men who were seen between April 2011 and January 2014 were analyzed for the study. Disease-related information, outside imaging, treatments, and whether the patient was imaged and/or offered urethroplasty prior to treatment were evaluated. If the men could not recall whether they had been offered urethroplasty, but their records documented that they were offered it, they were counted as having been offered it as a treatment option.

Watch: Bulbospongiosus sparing dorsal onlay bulbar urethroplasty

Seventy-four of the 103 men were 31 to 70 years of age. More than half (55) had bulbar urethral strictures, 17 had panurethral strictures, and 20 had strictures in multiple locations.

Of the 103 men, 91 had prior treatment.

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