Spencer J, et al. – This study was carried out to assess clinical and patient–reported urinary and sexual outcomes after a long–segment stricture repair using the one–sided urethral dissection, penile invagination and dorsal BMG onlay technique described by Kulkarni. As per the data, durable patency in most patients is illustrated in this study. Moreover, patient–reported outcome measures demonstrate an improvement in urinary function and moderate effect on sexual function. In addition, transient penile chordee was evident in 25% of patients.

Methods

• Between January 2002 to April 2016 , analysts reviewed patients from four institutions after single-stage repairs for long-segment urethral strictures (> 8 cm).
• In this study, technique described by Kulkarni et al was applied in all cases.
• Uroflowmetry (Qmax), post-void residuals (PVR) were included as clinical outcomes.
• Thereafter, PROMs included IPSS survey, SHIM, Male Sexual Health Questionnaire (MSHQ-EjS) and Global Response Assessment questionnaire (GRA) to measure voiding, sexual, ejaculatory symptoms and overall improvement respectively.

Results

• They enrolled 73 patients with a minimum of 12-months follow-up.
• The evidence showed that the mean age and stricture length were 56(21-80) years and 13.6(8-21) cm respectively.
• 9/73(12%) strictures recurred at a mean follow-up of 44(12-162) months.
• They found that the mean baseline IPSS score of 23(7-24) decreased to 10(1-17) on follow-up (p <0.001).
• As per the data, 8/42 patients (21.4%) reported an increase and 6/42 patients (14.3%) decrease in SHIM following urethroplasty.
• They demonstrated that ejaculatory function on MSHQ-EjS improved after urethroplasty from 8 pre-operatively to 11 post-operatively (p<0.004).
• The obtained data indicate that all patients reported enhancement after urethroplasty on GRA questionnaire.
• The data indicated that post-void dribbling and chordee occurred in 45% and 25% of patients respectively.