Patient-reported outcomes after single-stage spiral preputial graft urethroplasty for panurethral strictures: a single-centre prospective study.

BACKGROUND

Panurethral strictures, involving the entire anterior urethra, present a significant reconstructive challenge. While buccal mucosal grafts are commonly used, limitations in graft length and donor site morbidity persist. The spiral preputial graft (SPG) offers a promising alternative, enabling long, hairless grafts without additional donor morbidity. This study prospectively evaluates patient-reported outcomes (PROs) following single-stage SPG urethroplasty for panurethral strictures.

METHODS

A prospective interventional study was conducted between January 2021 and June 2024 at a tertiary urology center. Fifty-five patients undergoing SPG urethroplasty were included. Exclusion criteria included Lichen Sclerosus, prior urethroplasty, and inadequate preputial skin. PROs were assessed preoperatively and postoperatively using the Lower Urinary Tract Symptom (LUTS) score, Visual Analogue Scale (VAS) for health status, treatment satisfaction, and quality of life (QoL) impact. Statistical significance was set at p < 0.05.

RESULTS

Median LUTS scores improved significantly from 18 to 2 (p < 0.001), and mean VAS scores increased from 59.36 to 84.4 (p < 0.001). QoL improvement was reported by 83.6% of patients. The overall success rate—defined as symptom relief without secondary endoscopic or open intervention—was 83.7%.

CONCLUSION

Single-stage SPG urethroplasty is a technically feasible, reproducible, and effective alternative to oral grafting for panurethral strictures. It results in significant improvements in urinary symptoms, health perception, and patient satisfaction. These findings support broader adoption of the SPG technique in appropriately selected patients, with an emphasis on integrating PROs into surgical outcome assessment.