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Advanced Male Urethral and Genital Reconstructive Surgery pp 373–385Cite as

Reconstruction of Failed Urethroplasty

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Part of the book series: Current Clinical Urology ((CCU))

Abstract

The overall incidence of bulbomembranous urethral stricture or bladder neck contracture after radiation therapy is roughly 3–16 %. Time to stricture presentation is usually delayed (24 months) and insidious. Radiation urethral strictures typically have an unhealthy or pale appearance on cystoscopy, with varying degrees of local tissue induration or dense fibrotic scarring. Radiation-induced urethral strictures are often refractory to urethrotomy or dilation and merely palliative and require successive treatments. Management methods include intermittent self-catheterization, off-label use of an endourethral prosthesis, excision and primary urethral anastomosis urethroplasty, onlay flap and graft urethroplasty, salvage prostatectomy with anastomotic urethrovesical urethroplasty, combined abdominoperineal urethroplasty, onlay flap urethroplasty, and supravesical urinary diversion surgery. Urethroplasty seems to be feasible and reasonably successful for RT strictures in the short term, with the best results with anastomotic urethroplasty.

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Author information

Authors and Affiliations

  1. Department of Urology, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX, 78234, USA

    Steven J. Hudak MD

  2. Department of Urology, UT-Southwestern Medical School, Dallas, TX, USA

    Allen F. Morey MD

Authors
  1. Steven J. Hudak MD
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  2. Allen F. Morey MD
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Corresponding author

Correspondence to Steven J. Hudak MD .

Editor information

Editors and Affiliations

  1. Department of Surgery Division of Urologic Surgery, Washington University School of Medicine, St. Louis, Missouri, USA

    Steven B. Brandes

  2. Department of Urology, University of Texas Southwestern Medical Center, Dallas, Texas, USA

    Allen F. Morey

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Hudak, S.J., Morey, A.F. (2014). Reconstruction of Failed Urethroplasty. In: Brandes, S., Morey, A. (eds) Advanced Male Urethral and Genital Reconstructive Surgery. Current Clinical Urology. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4614-7708-2_25

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  • DOI: https://doi.org/10.1007/978-1-4614-7708-2_25

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  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4614-7707-5

  • Online ISBN: 978-1-4614-7708-2

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