Outcomes of multistage (substitutions) urethroplasty

Eighteen patients were undergone stages urethroplasty. The mean age of the patients was 38.5 ± 2.3 years. The etiology of urethral stricture were prior medical procedures in 55.6% of cases, urethral trauma and subsequent failed urethroplasty in 38.9%, balanitis xerotica obliteraus (BXO-related) stricture in 5.6%. Stricture localized in the penile urethra 50%, in the bulbar and membranous parts in 17% and 5%, respectively and panurethral strictures were diagnosed in 27.8% of cases. Median (rank) the urethral stricture length was 6cm (4 -17 cm). Surgical treatment was stages. During the first stage (it were made all 18 patients) we created new urethral plate from the buccal mucosa graft (BMG). Primary engraftment of the new urethral plate was observed in 11 (61.1%) patients. Correction of new urethral plate was done in 6 (35.3%) patients, necrosis of the BMG was diagnosed in 1 (5.6%) case. The overall efficiency of the first stage (the ability of new urethral plate tubularisation) was 94.4%. The median time between stages equaled 7.5 months. The second (final) stage urethroplasty was performed in 16 patients. The overall efficiency of neourethra tubularisation was 93.8%. Positive outcomes of stages (substitutional) urethroplasty equaled 88.2%. Median follow-up was 14 months. None of the patients during the observation period did not need any management of the urethra.