Urethral stricture excision and primary end-to-end anastomosis: a single-tertiary center long-term experience

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Background: Urethral stricture represents a prevalent clinical entity in urological practice, with urethroplasty currently serving as the primary therapeutic approach for complex cases. This study aimed to analyze the efficacy of urethral stricture resection and primary end-to-end anastomosis for treating male urethral strictures and identify potential risk factors for postoperative recurrence. Methods: A retrospective analysis was conducted on 37 male patients who underwent this procedure at Peking University First Hospital between February 2018 and September 2024. Clinical data of the patients, including age, preoperative urinary tract infection, etiology of urethral stricture, location of urethral stricture, length of stricture segment, preoperative urethral surgery history, presence of bladder fistula, preoperative and postoperative quality of life (QoL) index, preoperative and postoperative International Prostate Symptom Scores (IPSS) score, postoperative regular dilation, and postoperative complications, were collected and analyzed using statistical methods. Results: The median follow-up time for the patients was 57 [interquartile range (IQR), 39.5-66.5] months, and the stricture length was 20 (IQR, 10-30) mm. The rate of recurrent stricture was 40.54% (15/37), with a median time from surgery to recurrence of 3 (IQR, 1-6) months. The preoperative and postoperative QoL and IPSS scores showed significant differences (P<0.05). Sexual dysfunction and urinary tract infections were the most common postoperative complications. There was no statistically significant difference in efficacy between posterior and anterior urethral strictures. Conclusions: We provided clinical information on stricture resection and end-to-end anastomosis in the treatment of male urethral strictures, providing a baseline reference for relevant research. Individualized assessment and management are crucial for improving surgical success rates and patient QoL.

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