Delayed Single Stage Perineal Posterior Urethroplasty.

OBJECTIVE To determine the delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture/distraction defect. STUDY DESIGN Descriptive case series. PLACE AND DURATION OF STUDY Department of Urology, Jinnah Postgraduate Medical Centre, Karachi, from January 2009 to December 2011. METHODOLOGY Patients were selected for delayed single stage perineal posterior urethroplasty for treatment of posterior urethral stricture / distraction defect. All were initially suprapubically catheterized followed by definitive surgery after at least 3 months. RESULTS Thirty male patients were analyzed with a mean follow-up of 10 months, 2 patients were excluded as they developed failure in first 3 months postoperatively. Mean patient's age was 26.25 ± 7.9 years. On follow-up, 7 patients (23.3%) experienced recurrent stricture during first 10 months. Five (16.6%) patients were treated successfully with single direct visual internal urethrotomy. Two patients (6.6%) had more than one direct visual internal urethrotomy and considered failed. Re-do perineal urethroplasty was eventually performed. The overall success rate was 93.3% with permissive criteria allowing single direct visual internal urethrotomy and 76.6% with strict criteria allowing no more procedures postoperatively. CONCLUSION Posterior anastomotic urethroplasty offers excellent long-term results to patients with posterior urethral trauma and distraction defect even after multiple prior procedures.