To determine the long-term outcome of endoscopic urethrotomy for primary urethral strictures based on a population-based approach.
Analysis of a nation-wide data base of all patients with urethral stricture disease who underwent endoscopic urethrotomy as primary intervention between January 2006 and December 2007. All patients were followed individually for 7 to 9 years. Frequencies and types of surgical reinterventions were documented. Repeat surgical interventions were stratified into three treatment types: urethrotomy, urethroplasty and end-to-end urethral anastomosis.
A total of 1203 men underwent urethrotomy during the index period. Median patient age was 63 years (SD ±15.7), range 20-85 years. A total of 136 patients (11%) died during follow-up. Within the follow-up period, 932 patients (78%) received no further surgical re-intervention for recurrent disease, and 176 patients (14.6%) required one, 53 (4.5%) two and 41 (3.4%) three or more procedures. The mean number of reinterventions was 1.5 per patient, the lowest reintervention rate was in patients aged 80 or older (13.9%). In 236 cases (68%) at least one repeat urethrotomy was performed. An open reconstruction was performed in 87 cases (32%) with urethroplasty in 21 patients (24%) and end-to-end anastomosis in 66 patients (76%). The mean duration until reintervention was 29.5 months.
This long-term population-based study suggests that the invasive re-treatment rate following initial urethrotomy is 22% within 8 years and lowest in the advanced age cohort.
BJU international. 2021 Jan 23 [Epub ahead of print]
Klaus Eredics, Florian Röthlin, David Wachabauer, Sabina Sevcenco, Martin Marszalek, Karl Mock, Stephan Madersbacher
Department of Urology., Austrian National Public Health Institute (Gesundheit Österreich GmbH/GÖG)., Department of Urology, Klinik Favoriten.