ANALYSIS OF FACTORS CONTRIBUTING TO SUCCESS OR FAILURE OF 1-STAGE URETHROPLASTY FOR URETHRAL STRICTURE DISEASE

We reviewed charts with adequate documentation and followup (mean 24.6 months) between 1970 and 1987 of 110 patients who had undergone 1-sta ge urethroplasty for urethral stricture disease at our institutions. T wo age peaks were observed, 1 in the younger population (21 to 30 year s old) with traumatic strictures (50% of all strictures) and 1 in elde rly men (61 to 70 years old) with mainly post-inflammatory strictures (28.2% of all strictures). The majority of all strictures (63.6%) were in the bulbous urethra. Only strictures induced by trauma were locate d in the membranous urethra (total 28.2%). A patch graft repair was us ed in 49.1% of all cases, an end-to-end technique in 29.1% and a trans pubic repair in 21.8%. Overall, a 57% rate of excellent results was ob served with 24% failures. The results were best for patch graft repair s (65% excellent), followed by end-to-end repairs (56% excellent) and transpubic repairs (42% excellent). The choice of the surgical approac h in urethral stricture surgery is dictated by the location of the str icture. The location in turn is dependent on the etiology of the stric ture. Consequently, the cause of the stricture affects the location an d character of the stricture and, therefore, has an immediate impact o n the choice of the surgical approach and, thus, the outcome of the pa tient. The failure rate doubled overall when the patients had a previo us manipulation for the stricture disease or if the urine was infected preoperatively despite antibiotic coverage. While our patient populat ion may not be representative for other institutions, some general con clusions regarding proper management and treatment selection can be dr awn from our experience.