Reconstructing the reconstructed: Outcomes of redo-urethroplasty for recurrent urethral strictures.

INTRODUCTION

In this study, we aimed to evaluate the results of redo-urethroplasty and to determine the risk factors contributing to the recurrence of stricture.

METHODS

Male patients with a history of urethroplasty who underwent redo-urethroplasty were retrospectively evaluated and included in the study. Classifications were made according to patient characteristics, features of the stricture, and the surgical procedure performed. Success criteria was defined as anatomical success, which was determined by the resistance-free passage of a 16-Fr flexible cystoscope through the reconstructed urethral lumen. After identifying the influencing factors, univariate and multivariable logistic regression analyses were conducted to determine the predictors for recurrence.

RESULTS

A total of 396 male patients who underwent urethroplasty were evaluated, with 76 patients meeting the established criteria for inclusion. The mean age was 42.3 (10-81) years, and the average follow-up period was 44 (13-78) months. The majority of patients (54%) had bulbar strictures, and the average stricture length was 4.8 ± 2.4 (1.3-12) cm. Treatment success was achieved in 72.4% of patients. In univariate analyses, factors statistically significantly (P < .05) associated with recurrence included smoking, diabetes mellitus, stricture length, etiology, and the presence of complications. In the multivariable logistic regression analysis, presence of complications remained statistically significant (P < .05) as an independent predictor of recurrence.

CONCLUSIONS

Smoking, diabetes mellitus, stricture length, etiology, and postoperative complications were significantly associated with stricture recurrence. These results suggest that patient-related, stricture-related, and perioperative factors influence recurrence risk after redo-urethroplasty.