UP-105 24 months Follow up of Dorsal Buccal Mucosal Graft Urethroplasty for Vesico-Urethral Anastomotic Stricture Post radical Prostatectomy
Thursday June 27, 2019 from
TBD
Presenter

Waleed Shabana, Canada

urology

Noethen Ontario School of Medicine

Abstract

24 months follow up of dorsal buccal mucosal graft urethroplasty for vesico-urethral anastomotic stricture post radical prostatectomy

Walid Shahrour1, Waleed Shabana1, Ahmed Kotb1, Owen Prowse1, Thomas Tablowski1, Hazem Elmansy1.

1Urology Dapartment, Northen Ontario School of Medicine, Thunder Bay, ON, Canada

Introduction: To assess urinary functional and erectile outcomes after 2 years post dorsal buccal mucosal graft (BMG) for the repair of refractory vesico-urethral anastomotic stricture/stenosis (VUAS) post open radical prostatectomy.

Methods: We retrospectively reviewed collected data of patients underwent buccal mucosa graft urethroplasty following at least 3 interventions after urethrovesical anastomotic stricture/stenosis post radical prostatectomy. Patients were included if they completed 24 months after surgery. Patients demographics, preoperative continence status, number of dilations, and urine flow preoperatively and postoperatively were collected. Trial of void and retrograde urethrogram were done after 3 weeks. Patients were followed at 3,9,15 and 24 months by flowrate, postvoiding residual urine volume, cystourethroscopy and institutional standardized non-validated questionnaires.

Results: All patients had received adjuvant radiotherapy. Strictures were in the anastomotic site and median stricture length was 2.5 cm (2-3). All patients were incontinent preoperatively with mean preop flow of 5 mL/s (3-7 mL/s). Mean operative time and blood loss were 177 minutes and 250 mL respectively. We did not record any case of intraoperative rectal injuries. Erectile function remained mostly unchanged compared to preoperative status. Median postoperative urine flow at 3,6, 12 and 24months was 20, 22,25 and 26 mL/s respectively. Success rate was 100% at 24 months. 40% of patients reported very satisfied with surgery.one patients had AUS subsequently.

Conclusion: Long term follow up of dorsal BMG urethroplasty post vesico-urethral anastomotic stricture/stenosis has a promising urinary functional outcome Dorsally placed BMG eliminate risk of rectal injuries associated with other approaches.


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