AUA 2013: Urethroplasty efficacious for RT-induced stenosis

Anastomotic urethroplasty appears to be effective for managing radiotherapy-induced posterior urethral stenosis, researchers say.

A total of 72 men at three institutions (Northwestern University Feinberg School of Medicine, Chicago; Washington University, St. Louis; and University of Texas Southwestern Medical Center, Dallas) underwent anastomotic reconstruction for stenosis. The surgery, which involved complete scar excision, mobilization of the urethra, and bulbomembranous primary anastomosis, was similar among the institutions, reported first author Lee C. Zhao, MD, of UT Southwestern Medical Center, who worked on the study with Allen F. Morey, MD, of and co-authors. Mean time from radiotherapy to surgery was 6.3 years.

The procedure was successful in 52 of 72 patients, for a success rate of 72%, Dr. Zhao said. Mean follow-up was 2.7 years. De novo incontinence occurred in 19% of patients. Fifty-two percent of patients had postoperative incontinence compared with 48% of patients before surgery. Mean time to recurrence, which was defined as “cystoscopic identification of urethral narrowing to less than 16F in diameter,” was 10 months.

“While the results may not be quite as high as, say, for pelvic fracture urethral injuries, the anastomotic urethroplasty can be performed in this particular situation,” Dr. Zhao said in conclusion.