Outcome of Bulbar Urethra End to End Anastomosis in a Single Centre

Abstract

Aims : A retrospective evaluation and statistical analysis of outcome in patients who underwent bulbar end to end anastomosis for stricture of bulbar urethra in Army Hospital.

Methodology: 50 patients with average age of 35 years who underwent bulbar end to end anastomosis between 2005 and 2009 at Army Hospital were analyzed. Mean follow up was 24 months. Stricture etiology was catheter induced 40%, perineal trauma 30%, infection 13%, instrumentation 10% and unknown in 7%. Stricture length was 1cm (59%), 1 to 2 cm (37%) and above 2cm (4%). 30% of the patients were previously subjected to multiple dilatations and internal urethrotomy and clinical outcome was considered failure if postoperative instrumentation was required. Postoperative sexual dysfunction was judged using nonvalidated questionnaire.

Results: Of the 50 cases, 80% were successful and treatment failure was 20 %. Failed cases are Managed with OIU and buccal mucosal graft and are being followed. Ten patients were unsatisfied with there sexual function out of which 5 had ejaculatory dissatisfaction, 3 with compromised erection and 2 had decreased glans sensitivity.

Conclusion: Bulbar end to end anastomosis has success rate of 80%, with better outcome in fresh cases than in previously intervened cases. Sexual outcome is successful in 80%.

Key words: bulbar urethra; stricture; anastomosis; outcome

DOI: http://dx.doi.org/10.3126/mjsbh.v9i2.5024

Medical Journal of Shree Birendra Hospital Vol.9(2) 2010: 38-41