Outcomes of Staged Urethroplasty for Distal Urethral BXO: The Whiston Hospital Experience

Published Date: 20th September 2024

Publication Authors: Pina. IM, Floyd Jr. MS

Introduction
Distal urethral disease due to balanitis xerotica obliterans is managed by staged urethroplasty. The first stage involves urethrectomy and replacement of the diseased urethral plate with a buccal graft. The second stage involves tubularisation and reconstructing the urethra. The purpose of this study was to analyse the final outcomes of staged urethroplasty.

Methods
All second stage graft urethroplasties undertaken by a single surgeon were included. Preoperative symptoms at referral and at 3 months post operatively were recorded using validated questionnaires. Intermediate revision rates, complications and length of time between first and second stages were recorded.

Results
A total of 10 second stage urethroplasties were performed with a mean age of 38 years (range 24–52). All underwent prior buccal graft substitution with 1 additional lingual graft. Only 2 patients required intermediate revision BUMG graft post first stage. Mean preoperative IPSS and Qaly Scores were 13 and 5 reducing to 3 and 1 respectively 3-months post operatively. Mean Preoperative IIEF 5 scores were 22 and 25 postoperatively. Mean preoperative UPROM scores were 14 reducing to 3 post operatively. A total of 90% stood to void post operatively. Histology confirmed BXO in all cases with one case of PEIN. The mean time to urethral closure was 17 months (range 9–31). One patient required a meatal revision at 6 months. One patient had a UTI post catheter removal and one wound infection was detected. No fistulae occurred.

Conclusions
Staged graft urethroplasty for BXO has been successfully established with encouraging results.

Pina, IM; Floyd Jr, MS. (2024). Outcomes of Staged Urethroplasty for Distal Urethral BXO: The Whiston Hospital Experience. European Urology Open Science. 67(Supplement 2), p.S14. [Online]. Available at: https://dx.doi.org/10.1016/j.euros.2024.07.027 [Accessed 2 October 2024]

 

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