Reflective Research of Single-Stage versus Two-Stage Urethroplasty to Better Define Best Therapy of Penile Urethral Strictures: A Comparative Longitudinal Study

Abstract

Aim: To determine whether single-stage is better than the two-stage urethroplasty for the therapy of penile urethral strictures

Study design: A comparative longitudinal study

Place and duration: This study conducted at Armed Forces Institute of Urology Rawalpindi, Pakistan between June 2020 to June 2021

Methodology: A reflective opinion on penile urethroplasties executed at a single center . The patients who had penile urethroplasty were included in this study. At six and 12 months, the main result was urethral patency, which was bounded as the capacity to pass the cystoscope with ease ranging from 16 to 17 Fr. The development of 90-day problems was the secondary result. Complications from both the first and second stages were covered in two-stage procedures.

Results: There was a total of 100 single-stage series of steps (48 buccal mucosal graft which is BMG and 52 penile fasciocutaneous flap [PFF]) and 52 two-stage steps conducted. The median stricture length did not differ across groups (p=0.25). Restriction on etiology, area, age, weight, past redesign, or urethroplasty technique was not shown as to link with failure in a Cox regression analysis. There was no difference in success rates comparing surgical procedures according to log-rank testing (91 percent [47/52] PFF vs. 83 percent [39/47] BMG vs. 87 percent [45/52] two-stage). A complication was experienced by 39% (60/154) of patients (51 percent [27/53] PFF vs. 29 percent [14/48] BMG vs. 36 percent [18/52] two-stage).The only predictor linked with the advancement of the problem was the urethroplasty technique; the odds ratio for PFF was 3.1 (p=0.009) and for two-stage was 1.4 (p=0.43) when compared to BMG.

Conclusions:  The favorable result of various penile urethroplasty procedures appear to be comparable. When appropriate, the shift to a single-stage BMG seems to be based on the patient undergoing some procedures than with a two-stage repair and having a lower complexity profile than with a single-stage PFF, all without sacrificing success rates.