APPLICATION OF URETHROPLASTY IN THE TREATMENT OF MALE URETHRAL STRICTURES: A RETROSPECTIVE ANALYSIS OF 60 CLINICAL CASES

INTRODUCTION. Urethral strictures in men occur with a frequency of approximately 0.5% in developed countries. Diagnosis is based on the results of uroflowmetry, retrograde urethrography, and cystourethroscopy. Minimally invasive treatment methods, such as urethral dilation or internal optical urethrotomy, are characterized by high recurrence rates. Meanwhile, modern clinical guidelines recommend urethroplasty as a more effective approach. The high incidence of combat trauma as a result of the armed aggression of the russian federation makes the issue of treatment of urethral strictures particularly relevant. This article presents an analysis of our center’s experience with the application of the urethroplasty technique. MATERIALS AND METHODS. A retrospective analysis was conducted of patients treated for urethral strictures and distraction defects using urethroplasty at our center over 3 years. The study included all relevant cases observed in our clinic. RESULTS. The sample consisted of 60 patients with an average age of 43.6 years. The primary complaint in all patients (63%) was a weak urine stream. Uroflowmetry was performed in 35% of patients, retrograde urethrography in 87%, and cystourethroscopy in 23%. In 50% of cases, strictures were of traumatic origin, 23% were idiopathic, and 18% were iatrogenic. The average stricture length was 2.55 cm. In 85% of patients, no further interventions were required in the postoperative period. However, four patients underwent repeat urethroplasty, three underwent internal optical urethrotomy, one performed periodic self-dilation, and one case was deemed unreconstructable. DISCUSSION. The primary techniques used were augmentation urethroplasty with buccal grafts and anastomotic urethroplasty. Success was defined as the absence of need for repeat interventions or surgical manipulations. The PROM-USS questionnaire was used to evaluate the effectiveness of surgical treatment in patients with urethral strictures. Complications most frequently occurred in the treatment of complex or recurrent strictures, which accounted for 43% of all cases. Overall, the obtained results correlate with data reported in the literature.