Safety and Surgical Outcomes of Same-day Anterior Urethroplasty

Urology. 2017 Apr:102:229-233. doi: 10.1016/j.urology.2016.12.003. Epub 2017 Jan 9.

Abstract

Objective: To evaluate the safety and feasibility of same-day anterior urethroplasty at our institution and define predictors of postoperative admission and surgical failure.

Methods: We retrospectively reviewed the charts of 118 consecutive anterior urethroplasties performed at a tertiary care center. Data were analyzed to detect predictors of postoperative admission and urethroplasty failure. The 30-day complications and long-term outcomes were compared between same-day and admitted patients.

Results: Ninety-two patients (78%) were discharged on the day of surgery. A penile stricture location compared with a bulbar stricture location (odds ratio: 13.4, P = .009) and having undergone more than 3 prior endoscopic stricture interventions (odds ratio: 10.2, P = .001) were significantly associated with postoperative admission. Patients with a ventral onlay approach were more likely to be discharged home (P = .03), whereas patients with combined repairs were more likely to be admitted (P = .04). Same-day urethroplasty did not increase 30-day postoperative complications, patient emergency room visits, unplanned clinic visits, or phone calls. Success rates did not differ between same-day (89%) and admitted (79%) cohorts, and no individual stricture characteristic was predictive of urethroplasty failure.

Conclusion: Same-day anterior urethroplasty is safe and feasible and could help increase utilization of urethroplasty for urethral stricture disease.

MeSH terms

  • Female
  • Humans
  • Long Term Adverse Effects / diagnosis*
  • Long Term Adverse Effects / epidemiology
  • Male
  • Middle Aged
  • Patient Readmission / statistics & numerical data
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / epidemiology
  • Quality Improvement
  • Retrospective Studies
  • Time-to-Treatment
  • United States
  • Urethra / pathology
  • Urethra / surgery
  • Urethral Stricture / diagnosis
  • Urethral Stricture / surgery*
  • Urologic Surgical Procedures* / adverse effects
  • Urologic Surgical Procedures* / methods