Objective: The success of urethroplasty de- pends on a well-vascularized urethra, and in graft procedures, also on a healthy and well-vascular- ized graft bed for neovascularization. Elderly pa- tients have an increased comorbid burden that may result in decreased penile and urethral blood flow. Therefore, we aimed to investigate whether age is an independent determinant of surgical suc- cess in patients undergoing urethroplasty.
Material and Methods: The data of male patients who underwent urethroplasty (Exci- sion-primary anastomosis and buccal mucosa graft) between 2015 and 2020 in our clinic were retrospectively analyzed. Urethroplasty success was defined as no urethral intervention required for at least one year of follow-up. Patients under the age of 60 were matched in a 1: 1 ratio with pa- tients aged 60 and over, according to the length of the stricture and the type of operation. Patient characteristics were compared between the two age groups. Factors affecting success were evalu- ated with multivariate logistic regression analysis. Results: Nineteen patients (n= 8 excision-pri- mary anastomosis, n= 11 buccal mucosa graft) aged 60 years and older were matched with those <60 years of age. Mean age and follow-up period were 41.9±12.6 and 67.9±4.8 years (p= 0.001), 27.3±8.7 and 24.1±10.9 months (p= 0.325) for <60 years and ≥60 years old groups, respectively. Presence of iatrogenic etiology (p= 0.026), comor- bidity (p= 0.007) and coronary artery disease (p= 0.027) were more common in the group over 60 years of age. No significant difference was found between the groups in terms of diabetes mellitus, body mass index, smoking, history of previous urethral surgery, number of previous direct vision internal urethrotomy procedures, location of stricture, and success rates. Stricture length was the only significant clinical factor predict- ing success (p= 0.044).
Conclusion: Urethroplasty success is affected by the length of the stricture, but not by age. Urethroplasty can be performed with similar success rates in elderly patients after evaluating the length of the stricture.
Keywords: Urethral stricture, urethroplasty, age
ABSTRACT
Objective: The success of urethroplasty de- pends on a well-vascularized urethra, and in graft procedures, also on a healthy and well-vascular- ized graft bed for neovascularization. Elderly pa- tients have an increased comorbid burden that may result in decreased penile and urethral blood flow. Therefore, we aimed to investigate whether age is an independent determinant of surgical suc- cess in patients undergoing urethroplasty.
Material and Methods: The data of male patients who underwent urethroplasty (Exci- sion-primary anastomosis and buccal mucosa graft) between 2015 and 2020 in our clinic were retrospectively analyzed. Urethroplasty success was defined as no urethral intervention required for at least one year of follow-up. Patients under the age of 60 were matched in a 1: 1 ratio with pa- tients aged 60 and over, according to the length of the stricture and the type of operation. Patient characteristics were compared between the two age groups. Factors affecting success were evalu- ated with multivariate logistic regression analysis. Results: Nineteen patients (n= 8 excision-pri- mary anastomosis, n= 11 buccal mucosa graft) aged 60 years and older were matched with those <60 years of age. Mean age and follow-up period were 41.9±12.6 and 67.9±4.8 years (p= 0.001), 27.3±8.7 and 24.1±10.9 months (p= 0.325) for <60 years and ≥60 years old groups, respectively. Presence of iatrogenic etiology (p= 0.026), comor- bidity (p= 0.007) and coronary artery disease (p= 0.027) were more common in the group over 60 years of age. No significant difference was found between the groups in terms of diabetes mellitus, body mass index, smoking, history of previous urethral surgery, number of previous direct vision internal urethrotomy procedures, location of stricture, and success rates. Stricture length was the only significant clinical factor predict- ing success (p= 0.044).
Conclusion: Urethroplasty success is affected by the length of the stricture, but not by age. Urethroplasty can be performed with similar success rates in elderly patients after evaluating the length of the stricture.
Keywords: Urethral stricture, urethroplasty, age