One-Stage Urethroplasty for Strictures at a Rural Hospital
Introduction: St Mary’s Mission Hospital manages many inflammatory and traumatic urethral strictures. Previously, we treated strictures with dilatation, but high recurrence and poor patient satisfaction necessitated adoption of reconstructive procedures since 2017. Objective: To review the scope, ou...
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| Format: | Article |
| Language: | English |
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Surgical Society of Kenya
2019-01-01
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| Series: | The Annals of African Surgery |
| Subjects: | |
| Online Access: | https://www.annalsofafricansurgery.com/one-stage-urethroplasty-for-strictu |
| _version_ | 1811282007104159744 |
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| author | Winston Ominde Makanga Christian A Agbo |
| author_facet | Winston Ominde Makanga Christian A Agbo |
| author_sort | Winston Ominde Makanga |
| collection | DOAJ |
| description | Introduction: St Mary’s Mission Hospital manages many inflammatory and traumatic urethral strictures. Previously, we treated strictures with dilatation, but high recurrence and poor patient satisfaction necessitated adoption of reconstructive procedures since 2017. Objective: To review the scope, outcome and complications of urethroplasties using data collected prospectively. Methods: All cases of one-stage urethroplasty were included. Patient biodata and pre-operative adverse factors were collected and analyzed. Results: 23 male patients ranging in age from 24 to 74 years were studied: 9 strictures were inflammatory (40%), 9 were traumatic (40%), 3 (20%) were recurrent. Nineteen strictures were in the bulbar urethra (83%), 2 were cases of penile strictures and 1 case each of pan-urethral stricture and pelvic floor urethral distraction defect. Of the 23 procedures, 13 were simple anastomosis (57%), 5 were dorsal buccal mucosa graft (BMG) urethroplasty (22%), 2 were cases of non-transecting anastomotic urethroplasty, and 1 case each of ventral BMG urethroplasty and Johansson’s and Kulkarni’s panurethroplasty. The overall complication rate was 40% (9 patients). Four patients (17%) had recurrence; 2 had fistula and 1 case each of persistent UTI, erectile dysfunction and periurethral abscess. Three of the four recurrences had undergone BMG urethroplasty. All cases of simple anastomosis had no recurrence. Conclusion: Our centre has embraced diverse urethroplasties for a wide scope of patients. This study found a significant complication rate for substitution urethroplasties, suggesting a need for careful patient selection and an improvement in technique. |
| first_indexed | 2024-04-13T01:43:53Z |
| format | Article |
| id | doaj.art-2c9aa746ce1b43e6818572d412a37296 |
| institution | Directory Open Access Journal |
| issn | 1999-9674 2523-0816 |
| language | English |
| last_indexed | 2024-04-13T01:43:53Z |
| publishDate | 2019-01-01 |
| publisher | Surgical Society of Kenya |
| record_format | Article |
| series | The Annals of African Surgery |
| spelling | doaj.art-2c9aa746ce1b43e6818572d412a372962022-12-22T03:08:06ZengSurgical Society of KenyaThe Annals of African Surgery1999-96742523-08162019-01-011611619One-Stage Urethroplasty for Strictures at a Rural HospitalWinston Ominde Makanga0Christian A Agbo1St Mary’s Mission Hospital, NairobiJos University Teaching Hospital, NigeriaIntroduction: St Mary’s Mission Hospital manages many inflammatory and traumatic urethral strictures. Previously, we treated strictures with dilatation, but high recurrence and poor patient satisfaction necessitated adoption of reconstructive procedures since 2017. Objective: To review the scope, outcome and complications of urethroplasties using data collected prospectively. Methods: All cases of one-stage urethroplasty were included. Patient biodata and pre-operative adverse factors were collected and analyzed. Results: 23 male patients ranging in age from 24 to 74 years were studied: 9 strictures were inflammatory (40%), 9 were traumatic (40%), 3 (20%) were recurrent. Nineteen strictures were in the bulbar urethra (83%), 2 were cases of penile strictures and 1 case each of pan-urethral stricture and pelvic floor urethral distraction defect. Of the 23 procedures, 13 were simple anastomosis (57%), 5 were dorsal buccal mucosa graft (BMG) urethroplasty (22%), 2 were cases of non-transecting anastomotic urethroplasty, and 1 case each of ventral BMG urethroplasty and Johansson’s and Kulkarni’s panurethroplasty. The overall complication rate was 40% (9 patients). Four patients (17%) had recurrence; 2 had fistula and 1 case each of persistent UTI, erectile dysfunction and periurethral abscess. Three of the four recurrences had undergone BMG urethroplasty. All cases of simple anastomosis had no recurrence. Conclusion: Our centre has embraced diverse urethroplasties for a wide scope of patients. This study found a significant complication rate for substitution urethroplasties, suggesting a need for careful patient selection and an improvement in technique.https://www.annalsofafricansurgery.com/one-stage-urethroplasty-for-strictustrictureurethroplastyone-stagecomplicationsoutcome |
| spellingShingle | Winston Ominde Makanga Christian A Agbo One-Stage Urethroplasty for Strictures at a Rural Hospital The Annals of African Surgery stricture urethroplasty one-stage complications outcome |
| title | One-Stage Urethroplasty for Strictures at a Rural Hospital |
| title_full | One-Stage Urethroplasty for Strictures at a Rural Hospital |
| title_fullStr | One-Stage Urethroplasty for Strictures at a Rural Hospital |
| title_full_unstemmed | One-Stage Urethroplasty for Strictures at a Rural Hospital |
| title_short | One-Stage Urethroplasty for Strictures at a Rural Hospital |
| title_sort | one stage urethroplasty for strictures at a rural hospital |
| topic | stricture urethroplasty one-stage complications outcome |
| url | https://www.annalsofafricansurgery.com/one-stage-urethroplasty-for-strictu |
| work_keys_str_mv | AT winstonomindemakanga onestageurethroplastyforstricturesataruralhospital AT christianaagbo onestageurethroplastyforstricturesataruralhospital |