MP55-06 THE ROLE OF POST-OPERATIVE IMAGING AFTER VENTRAL ONLAY BUCCAL MUCOSAL GRAFT BULBAR URETHROPLASTY

PURPOSE: Our primary objective is to determine the incidence of extravasation on imaging at time of catheter removal after ventral onlay buccal mucosal graft (BMG) urethroplasty. METHODS: This is a single center retrospective cohort study of patients who underwent ventral onlay BMG bulbar urethroplasty from 2007-2017. Patients with imaging at the time of catheter removal were included. Urethroplasty success was defined as the ability to pass a 17 French cystoscope at the time of follow-up cystoscopy. RESULTS: 229 patients met inclusion criteria - 110 had a ventral onlay BMG and 119 had an augmented anastomotic urethroplasty (AAU) with a mean stricture length of 4.4 cm. Imaging consisted of a voiding cystourethrogram (VCUG) in 210 and retrograde urethrogram (RUG) in 19 at a median 21.7 days after surgery. The incidence of extravasation was 3.1% (7/229). Of patients who had a documented follow-up cystoscopy (60% [137/229]), those who extravasated on imaging had a worse urethroplasty success rate (60% [3/5]) compared to those who did not (94% [117/130]) (p-0.047). On multivariate analysis, those who had ≥5 endoscopic interventions were 9.6 times more likely to demonstrate extravasation (OR=9.6, p=0.0080). CONCLUSIONS: The incidence of radiologic extravasation after ventral onlay using a single BMG, with or without an AAU, is 3.1%. Given this low rate, it is reasonable to omit routine imaging at the time of foley removal in this population. It appears that extravasation may be associated with a worse cystoscopic patency rate, but does not lead to more complications.