Factors associated with restenosis and postoperative complications in patients undergoing buccal mucosal graft urethroplasty: retrospective analysis

Abstract

Background: Urethral stenosis is a challenging urological condition, and its management includes a variety of techniques broadly classified as endoscopic approaches or reconstructive procedures using graft urethroplasty. Buccal mucosal graft urethroplasty is currently considered the gold standard for the treatment of anterior urethral stenosis. However, the literature remains inconclusive regarding the influence of patient-related factors on therapeutic success or failure, particularly with respect to restenosis. This study aimed to evaluate risk factors for urethral restenosis and postoperative complications following buccal mucosal graft urethroplasty. Methods: A retrospective review of medical records was conducted for patients with anterior urethral stenosis who underwent buccal mucosal urethroplasty between September 2012 and December 2019 at a public hospital in Curitiba, Paraná, Brazil. Results: A total of 51 patients were included in the analysis. No statistically significant patient-related risk factors for urethral restenosis were identified. However, a history of prior endoscopic prostate resection was associated with an increased risk of postoperative complications following urethroplasty, and this association was correlated with patient age. Conclusion: These findings contribute to identifying factors associated with postoperative complications, facilitating improved preoperative risk stratification and patient counseling. Recognizing patients at higher risk may enable clinicians to anticipate postoperative outcomes and tailor perioperative management after buccal mucosal graft urethroplasty.

Keywords: Urethra, urethral stenosis, reconstructive surgery, buccal mucosal graft urethroplasty