S.A. Vozianov, I.I. Gorpinchenko, S.N. Shamrayev, I.A. Babyuk, A.I. Boiko, A.L. Sharpilo, M.A. Ridchenko, S.I. Kozachihina, V.P. Stus, A.L. Suvaryan

The long-term results of open surgery in patients with complicated urethral strictures

The results of 1284 surgical correction of urethral stricture and its obliteration for the period 2003-2016 years in 895 patients were reviewed retrospectively. The open uretрroplasty performed in 72 (5,6%) patients with long (>2 sm) urethral strictures and its obliteration. These patients were divided into 4 groups: 1st - augmentation buccal mucosa urethroplasty - 15 (20,8%), 2nd - urethro-urethro- or urethro-prostatоanastomosis - 39 (54,2%), 3rd - substitution skin and fascial flap urethroplasty - 8 (11,1%), 4th - substitution buccal mucosa-graft urethroplasty - 10 (13,9%). The average length of strictures was in 1st gr. - 2,2±0,1 sm; 2nd gr. - 3,3±0,8 sm; 3rd gr. - 3,3±0,9 sm аnd 4th gr. - 5,3±0,8 sm. An average difficulty grades of urethra strictures in 1, 2, 3, 4 groups were: 6,2±0,3; 6,8±0,7; 6,7±0,8; 9,1±0,9. The average length of recovery period of independent urination was: 1st gr. - 19,3±0,7 days, 2nd gr. - 16,6±0,7, 3rd gr. - 19,4±1,6 and in 4th gr. - 17,1±1,1 days. Complications of open corrections of urethral strictures in the early recovery period (30 days) were: acute urinary retention - 4 (5,5%) observations, orhoepidydymitis - 5 (6,9%), fistula perinealis - 3 (4,2%) (Clavien II). The recurrence of urethral stricture in long-term follow-up we observed in 6 (8,3%) patients (Clavien IIIb), but erectile dysfunction - in 18 (25,0%) (Clavien II-IIIb). Good result of primary open urethroplasty noted in 65 (90,3%) patients, but bad results - in 4 (5,5%), doubtfull results - in 3 (4,2%). The overall effectiveness of primary and redo urethroplasty was - 95,6%, with a mean follow-up -10,5±2,2 months.