Long-term followup of two-sided dorsal plus ventral oral graft bulbar urethroplasty: single center experience on 216 patients.

BACKGROUND Two-sided dorsal plus ventral oral graft urethroplasty is a new urethra-sparing technique suggested in tight bulbar strictures which are too severe for a simple one-side grafting. The aim is to evaluate long-term outcomes and the success predictive factors of this technique. METHODS A descriptive retrospective study was conducted on 216 patients undergone dorsal plus ventral graft urethroplasty for bulbar strictures between 2002 and 2018 in a single high-volume center by a single surgeon (EP). The primary outcome measure was stricture recurrence at follow-up. Surgical procedure was considered failed when any postoperative instrumentation was needed. Univariable and multivariable logistic regression analysis were performed. RESULTS Median follow-up was 98 months (IQR 41-131). Among the 216 patients, 188 (87%) were successful and 28 (13%) were failures. Most of the failures (78.4%) were observed during the first 7 years of follow-up, afterward failures were less frequently recorded. Stricture length <1.5cm and the absence of previous treatments resulted as independent success predictors (respectively p=0.04 OR 0.55 (0.29-0.99) and p=0.02 OR 0.23 (0.06-0.79). Age and stricture etiology were not significant predictors of surgical outcome. The limitation of our survey is that it is a retrospective single centre experience. Multicentric experiences from different centres should be performed. CONCLUSIONS After long-term follow-up in our wide series, the two-sided dorsal plus ventral oral graft bulbar urethroplasty showed a high success rate. Stricture length <1.5cm and the absence of previous treatments resulted as independent success predictors.