Surgical and patient-reported outcomes of staged urethroplasty for anterior urethral strictures: A comprehensive analysis

Objectives: To evaluate the efficacy of staged urethroplasty for complex anterior urethral strictures from both surgical and patient-reported outcome perspectives.

Methods: This retrospective study included 100 patients who underwent staged urethroplasty for anterior urethral strictures between May 2011 and June 2023. Anatomical success was defined as the ability to pass cystourethroscopy without resistance and the patient's ability to void without additional interventions. Patient-reported outcomes were evaluated using validated questionnaires, including the urethral stricture surgery patient-reported outcome measure, sexual health inventory for men (SHIM), and EuroQol 5-dimension (EQ-5D), administered pre-and postoperatively.

Results: At a median follow-up of 53 months, the anatomical success rate was 89.0%. Seventeen (17.0%) required revision surgery between stages. Perioperative complications occurred in 13 (13.0%). Significant improvements were observed in maximum flow rate (p < 0.0001), postvoid residual volume (p = 0.0006), total lower urinary tract symptoms (LUTS) scores (p < 0.0001), LUTS-specific quality of life (QOL) score (p < 0.0001), EQ-5D index score (p < 0.0001), and EQ-5D visual analog scale score (p < 0.0001). SHIM scores showed no significant change (p = 0.59). Overall, 93.5% of patients reported being either "satisfied" or "very satisfied" with the outcomes.

Conclusion: Staged urethroplasty demonstrates high anatomical success rates and significant improvements in urinary function and QOL without compromising erectile function. The high patient satisfaction rate supports its efficacy in treating complex anterior urethral strictures.