Urethroplasty among Elderly Men, Surgical Techniques and Outcomes
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Date
2024
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Scientific Research Publishing
Abstract
Urethroplasty remains the gold standard for the management
of urethral stricture. However, the treatment of stricture disease in the elderly
tends to be less invasive due to the presumption that they might not be able to
stand long hours of surgery and might have higher rates of recurrence due to
poor wound healing from microangiopathy. We present our experience with
the outcomes of urethroplasty among elderly men seen at the Komfo Anokye
Teaching Hospital from January 2012 to December 2021. Methods: This was
a retrospective review of data captured in the urology database on all patients
65 years and above who underwent urethroplasty at the hospital over the study
period. Data was obtained on patients’ demographics, stricture characteristics,
urethroplasty technique, and outcome. A successful outcome was defined as
peak flow rate > 15 mls/s, a patent urethra on retrograde urethrogram, patient
satisfaction with urine stream, or restoration of the normal stream of urine
with only one attempt at urethral calibration or internal urethrotomy post operatively.
Data was analyzed using PASW Statistics for Windows, Version
18.0. Results: Overall, 43 urethroplasties were done over the study period in
elderly men. The age range was 65 to 87 years. The commonest aetiology was
catheterization (62.79%) followed by urethritis (32.56%). Stricture length ranged
from 0.5 cm to 16 cm with a mean of 3.93 cm. Most patients (60.46%) had bul bar urethral strictures.
The repair methods employed were anastomotic ureth roplasty (62.80%), fasciocutaneous flap (FCF) ventral onlay (13.95%), buccal
mucosa graft (BMG) ventral onlay urethroplasty (4.65%), and staged urethrop lasty (4.65%). Three of the patients (6.98%)
had a combination of anastomotic and tissue transfer urethroplasty. The overall success rate was 88.37%. Com plications included three surgical site infections,
two urethral diverticula and one glans dehiscence. Conclusion: Elderly men tolerate urethroplasty well and
the procedure should not be denied solely based on age.
Description
This article is published by Scientific Research Publishing and is also available at DOI: 10.4236/oju.2024.143018
Keywords
Citation
Open Journal of Urology, 2024, 14, 179-187