Urethroplasty in patients older than 65 years

indications, results, outcomes and suggested treatment modifications.

Richard A. Santucci, Jack W. McAninch, Layla A. Mario, Atul Rajpurkar, Anuj K. Chopra, Kennon S. Miller, Noel A. Armenakas, Edward B. Tieng, Allen F. Morey

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

PURPOSE: Despite an aging population, the results of urethroplasty in elderly patients have not been extensively reported. We performed a multi-institutional review of urethroplasty results in 70 elderly males to determine outcomes. MATERIALS AND METHODS: We reviewed all urethroplasties performed on males older than 64 years with at least 6 months of followup at 4 medical centers. Stricture type varied and included anastomotic urethroplasty (44%), penile fasciocutaneous onlay flap (31%), Johanson urethroplasty (stage 1, 6%, stages 1 and 2, 4%), buccal mucosa grafts (7%), foreskin grafts (6%) and meatoplasty (1%). RESULTS: Stricture recurred in 11 (16%) patients, but was managed with a single direct visual internal urethrotomy or dilation in 5 of 11 patients, yielding a final success rate of 91%. Recurrent strictures were more common after fasciocutaneous flaps (7 of 22 cases, 32%) than end-to-end urethroplasty (2 of 31 cases, 6%, p <0.05). Compared to patients younger than 65 years there were more treatment failures, but this was not statistically significant. Perioperative complications were uncommon. Moderate bladder outlet obstructive symptoms developed in 3 patients due to benign prostatic hyperplasia. Notably 6 patients treated previously for post-radiation strictures did well without complications. CONCLUSIONS: Older men tolerate urethroplasty and these data indicate that therapy should not be withheld solely on the basis of age. The potential for impaired flap blood supply in this population is suggested but has not been proven. Benign prostatic hyperplasia must be considered in those patients who have decreased stream after stricture repair.

Original languageEnglish (US)
Pages (from-to)201-203
Number of pages3
JournalThe Journal of urology
Volume172
Issue number1
StatePublished - Jul 2004

Fingerprint

Pathologic Constriction
Prostatic Hyperplasia
Transplants
Foreskin
Inlays
Mouth Mucosa
Treatment Failure
Population
Dilatation
Urinary Bladder
Radiation
Therapeutics

ASJC Scopus subject areas

  • Urology

Cite this

Santucci, R. A., McAninch, J. W., Mario, L. A., Rajpurkar, A., Chopra, A. K., Miller, K. S., ... Morey, A. F. (2004). Urethroplasty in patients older than 65 years: indications, results, outcomes and suggested treatment modifications. The Journal of urology, 172(1), 201-203.

Urethroplasty in patients older than 65 years : indications, results, outcomes and suggested treatment modifications. / Santucci, Richard A.; McAninch, Jack W.; Mario, Layla A.; Rajpurkar, Atul; Chopra, Anuj K.; Miller, Kennon S.; Armenakas, Noel A.; Tieng, Edward B.; Morey, Allen F.

In: The Journal of urology, Vol. 172, No. 1, 07.2004, p. 201-203.

Research output: Contribution to journalArticle

Santucci, RA, McAninch, JW, Mario, LA, Rajpurkar, A, Chopra, AK, Miller, KS, Armenakas, NA, Tieng, EB & Morey, AF 2004, 'Urethroplasty in patients older than 65 years: indications, results, outcomes and suggested treatment modifications.', The Journal of urology, vol. 172, no. 1, pp. 201-203.
Santucci RA, McAninch JW, Mario LA, Rajpurkar A, Chopra AK, Miller KS et al. Urethroplasty in patients older than 65 years: indications, results, outcomes and suggested treatment modifications. The Journal of urology. 2004 Jul;172(1):201-203.
Santucci, Richard A. ; McAninch, Jack W. ; Mario, Layla A. ; Rajpurkar, Atul ; Chopra, Anuj K. ; Miller, Kennon S. ; Armenakas, Noel A. ; Tieng, Edward B. ; Morey, Allen F. / Urethroplasty in patients older than 65 years : indications, results, outcomes and suggested treatment modifications. In: The Journal of urology. 2004 ; Vol. 172, No. 1. pp. 201-203.
@article{a3980d86cc4145fd84ed099a79092633,
title = "Urethroplasty in patients older than 65 years: indications, results, outcomes and suggested treatment modifications.",
abstract = "PURPOSE: Despite an aging population, the results of urethroplasty in elderly patients have not been extensively reported. We performed a multi-institutional review of urethroplasty results in 70 elderly males to determine outcomes. MATERIALS AND METHODS: We reviewed all urethroplasties performed on males older than 64 years with at least 6 months of followup at 4 medical centers. Stricture type varied and included anastomotic urethroplasty (44{\%}), penile fasciocutaneous onlay flap (31{\%}), Johanson urethroplasty (stage 1, 6{\%}, stages 1 and 2, 4{\%}), buccal mucosa grafts (7{\%}), foreskin grafts (6{\%}) and meatoplasty (1{\%}). RESULTS: Stricture recurred in 11 (16{\%}) patients, but was managed with a single direct visual internal urethrotomy or dilation in 5 of 11 patients, yielding a final success rate of 91{\%}. Recurrent strictures were more common after fasciocutaneous flaps (7 of 22 cases, 32{\%}) than end-to-end urethroplasty (2 of 31 cases, 6{\%}, p <0.05). Compared to patients younger than 65 years there were more treatment failures, but this was not statistically significant. Perioperative complications were uncommon. Moderate bladder outlet obstructive symptoms developed in 3 patients due to benign prostatic hyperplasia. Notably 6 patients treated previously for post-radiation strictures did well without complications. CONCLUSIONS: Older men tolerate urethroplasty and these data indicate that therapy should not be withheld solely on the basis of age. The potential for impaired flap blood supply in this population is suggested but has not been proven. Benign prostatic hyperplasia must be considered in those patients who have decreased stream after stricture repair.",
author = "Santucci, {Richard A.} and McAninch, {Jack W.} and Mario, {Layla A.} and Atul Rajpurkar and Chopra, {Anuj K.} and Miller, {Kennon S.} and Armenakas, {Noel A.} and Tieng, {Edward B.} and Morey, {Allen F.}",
year = "2004",
month = "7",
language = "English (US)",
volume = "172",
pages = "201--203",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "1",

}

TY - JOUR

T1 - Urethroplasty in patients older than 65 years

T2 - indications, results, outcomes and suggested treatment modifications.

AU - Santucci, Richard A.

AU - McAninch, Jack W.

AU - Mario, Layla A.

AU - Rajpurkar, Atul

AU - Chopra, Anuj K.

AU - Miller, Kennon S.

AU - Armenakas, Noel A.

AU - Tieng, Edward B.

AU - Morey, Allen F.

PY - 2004/7

Y1 - 2004/7

N2 - PURPOSE: Despite an aging population, the results of urethroplasty in elderly patients have not been extensively reported. We performed a multi-institutional review of urethroplasty results in 70 elderly males to determine outcomes. MATERIALS AND METHODS: We reviewed all urethroplasties performed on males older than 64 years with at least 6 months of followup at 4 medical centers. Stricture type varied and included anastomotic urethroplasty (44%), penile fasciocutaneous onlay flap (31%), Johanson urethroplasty (stage 1, 6%, stages 1 and 2, 4%), buccal mucosa grafts (7%), foreskin grafts (6%) and meatoplasty (1%). RESULTS: Stricture recurred in 11 (16%) patients, but was managed with a single direct visual internal urethrotomy or dilation in 5 of 11 patients, yielding a final success rate of 91%. Recurrent strictures were more common after fasciocutaneous flaps (7 of 22 cases, 32%) than end-to-end urethroplasty (2 of 31 cases, 6%, p <0.05). Compared to patients younger than 65 years there were more treatment failures, but this was not statistically significant. Perioperative complications were uncommon. Moderate bladder outlet obstructive symptoms developed in 3 patients due to benign prostatic hyperplasia. Notably 6 patients treated previously for post-radiation strictures did well without complications. CONCLUSIONS: Older men tolerate urethroplasty and these data indicate that therapy should not be withheld solely on the basis of age. The potential for impaired flap blood supply in this population is suggested but has not been proven. Benign prostatic hyperplasia must be considered in those patients who have decreased stream after stricture repair.

AB - PURPOSE: Despite an aging population, the results of urethroplasty in elderly patients have not been extensively reported. We performed a multi-institutional review of urethroplasty results in 70 elderly males to determine outcomes. MATERIALS AND METHODS: We reviewed all urethroplasties performed on males older than 64 years with at least 6 months of followup at 4 medical centers. Stricture type varied and included anastomotic urethroplasty (44%), penile fasciocutaneous onlay flap (31%), Johanson urethroplasty (stage 1, 6%, stages 1 and 2, 4%), buccal mucosa grafts (7%), foreskin grafts (6%) and meatoplasty (1%). RESULTS: Stricture recurred in 11 (16%) patients, but was managed with a single direct visual internal urethrotomy or dilation in 5 of 11 patients, yielding a final success rate of 91%. Recurrent strictures were more common after fasciocutaneous flaps (7 of 22 cases, 32%) than end-to-end urethroplasty (2 of 31 cases, 6%, p <0.05). Compared to patients younger than 65 years there were more treatment failures, but this was not statistically significant. Perioperative complications were uncommon. Moderate bladder outlet obstructive symptoms developed in 3 patients due to benign prostatic hyperplasia. Notably 6 patients treated previously for post-radiation strictures did well without complications. CONCLUSIONS: Older men tolerate urethroplasty and these data indicate that therapy should not be withheld solely on the basis of age. The potential for impaired flap blood supply in this population is suggested but has not been proven. Benign prostatic hyperplasia must be considered in those patients who have decreased stream after stricture repair.

UR - http://www.scopus.com/inward/record.url?scp=3242784144&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=3242784144&partnerID=8YFLogxK

M3 - Article

VL - 172

SP - 201

EP - 203

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 1

ER -