Urethroplasty feasible for radiation-induced strictures

Chicago-Urethroplasty for radiation-induced bulbomembranous urethral stricture is feasible, although the risk of postoperative urinary incontinence appears to be much higher in this population than in men with strictures unrelated to radiation therapy, according to results of a multicenter study.

Reearchers from three academic centers- Northwestern University's Feinberg School of Medicine, Chicago, Washington University, St. Louis, and the University of Texas Southwestern Medical Center, Dallas-reported the results from a study including 30 men who underwent urethroplasty for radiation-induced strictures. Ninety percent of men presented with obstruction. The stricture was located in the bulbar urethra in 40% of men and was posterior/membranous in 60%; median stricture length was 3 cm (range, 1.5 to 7 cm).

In 25 men (84%), the reconstruction was completed via excision and primary anastomosis, while a graft was performed in three men (10%), and two (6%) had a flap procedure. Mean stricture length was shorter in men who received anastomotic repair compared with those having a substitution procedure (3 cm vs. 4.5 cm).

"This is a small, retrospective study, but to our knowledge, this multi-institution collaboration is one of the largest series of urethroplasty in radiation-induced strictures," Dr. Meeks said. "Our results indicate surgical reconstruction can be successful in this indication. However, it is important to discuss with patients preoperatively the relatively high risk of urinary incontinence."