Abdominal Transpubic Perineal Urethroplasty for Complex Posterior Urethral Strictures: An Experience of 10 Year. | [Journal of Surgery Pakistan • 2012]

Author(s):

1. Mazhar Khan: Department of Surgery, Hayatabad Medical Complex (HMC), Peshawar, Pakistan

2. Ain-ul-Hadi: Department of Surgery, Hayatabad Medical Complex (HMC), Peshawar, Pakistan

3. Farrukh Ozair Shah: Department of Surgery, Hayatabad Medical Complex (HMC), Peshawar, Pakistan

4. Shehzad Akbar Khan: Department of Surgery, Hayatabad Medical Complex (HMC), Peshawar, Pakistan

5. Zahid Aman: Department of Surgery, Hayatabad Medical Complex (HMC), Peshawar, Pakistan

Abstract:

Objective: To document the outcome of abdominal transpubic perineal urethroplasty for complex posterior urethral strictures. Study Design: Descriptive case series. Place & Duration of study Methodology: Surgical unit Hayatabad Medical Complex and Khyber Teaching Hospital Peshawar, from March 1999 to February 2009. Patients with complex posterior urethral stricture were included in this study. Pre operative evaluation included history, physical examination and laboratory investigations. Antegrade/retrograde urethrograms and cystourethroscopy were performed to evaluate bladder neck, and stricture site and length. Surgery was performed in lithotomy position through lower abdominal and perineal approaches. Patients were followed for 2 years. At each visit, ascending and descending urethrograms were performed and post operative complications were recorded. Results were graded as successful and failure based on stricture free rate at the end of 2 years. Results A total of 28 patients were managed The age range was 14-36 year with a mean age of 27.3 + 2.4 year. Urethral stricture was associated with false passages in 17.88% cases, periurethral cavity in 10.71% and urethrocutaneous fistula in 7.14% cases. Mean operation time was 3.5 hours and mean hospital stay was 6 days. Postoperative complications were recurrent stricture (17.86%), urethrocutaneous fistula (7.14%), perineal haematoma (7.14%), impotence (10.71%) and wound infection (10.71%). During follow up 89.29% patients were stricture free at the end of 2 years. Conclusion Abdominal transpubic perineal urethroplasty is an acceptable surgical approach in patients with complex posterior urethral stricture.

Page(s): 7-11

DOI: DOI not available

Published: Journal: Journal of Surgery Pakistan, Volume: 17, Issue: 1, Year: 2012

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