Korean J Urol.  2013 Oct;54(10):710-714.

Clinical Factors That Predict Successful Posterior Urethral Anastomosis With a Gracilis Muscle Flap

• Hwang JH
• Kang MH
• Lee YT
• Park DS
• Lee SR

Abstract

PURPOSE
We evaluated the preoperative clinical factors that affect the surgical outcome of posterior urethral anastomosis (PUA) with a gracilis muscle flap (GMF) to determine which factors predict benefit from the use of the GMF.
MATERIALS AND METHODS
This was a retrospective analysis of 49 patients who underwent a delayed PUA with a GMF. A successful clinical outcome was defined as achieving a peak urinary flow rate greater than 15 mL/s at 3 and 12 months postoperatively without evidence of stricture recurrence on a retrograde urethrogram or cystourethroscopy at 3 months postoperatively. Multiple clinical factors were evaluated by use of univariate and multivariate analyses.
RESULTS
The outcome of 21 of 49 patients (42.9%) was deemed successful. The mean age of the 49 patients was 37.2+/-13.5 years and the mean follow-up duration was 43.4+/-28.0 months. The length of the urethral defect was significantly shorter in patients with a successful outcome than in patients with an unsuccessful outcome (p=0.010). The outcome differed significantly depending on whether the patients had a previously successful urethroplasty (p=0.036) or whether they had suffered a pelvic bone injury (p=0.012). Multivariate logistic regression analyses revealed that a previous urethroplasty was the only preoperative clinical factor that significantly affected the surgical outcome in PUA with a GMF (odds ratio, 0.218; 95% confidence interval, 0.050 to 0.947; p=0.042).
CONCLUSIONS
A history of previous urethroplasty is a preoperative clinical factor that significantly affects the surgical outcome in PUA with a GMF; the procedure is more likely to be successful in patients who have not previously undergone urethroplasty.

Keyword

Surgical anastomosis; Surgical flap; Urethral stricture

MeSH Terms

Anastomosis, Surgical
Constriction, Pathologic
Follow-Up Studies
Glia Maturation Factor
Humans
Logistic Models
Muscles
Pelvic Bones
Recurrence
Retrospective Studies
Surgical Flaps
Urethral Stricture
Glia Maturation Factor

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