Long-term results of augmented and anastomotic urethroplasty: a systematic review and meta-analysis

Abstract

The aim of this study was to investigate the long-term results of urethroplasty in patients with urethral strictures who underwent surgical repair. Methods: A comprehensive search of databases was conducted to find the relevant articles. All studies investigated the following results were included: stricture recurrence, urinary incontinence, sexual dysfunction, and patient satisfaction done by either technique of end-to-end anastomosis (EEA) or graft-augmented urethroplasty (GAU). Selection and quality evaluation was performed using the Joanna Briggs Institute (JBI) checklist. Results: Thirty-eight studies were included in this systematic review. The data from 24 and 17 studies were extracted in GUA and EEA groups. In the GAU group, the rate of stricture recurrence was 12% according to a meta-analysis of 21 studies. The results for de novo erectile dysfunction has been reported in only two studies (0% and 0.9%). None of the studies have addressed urinary incontinence in this group. Patient satisfaction has been reported in two studies (84 and 97%). In EEA group, meta-analysis of 15 studies showed stricture recurrence of 10%. De novo erectile dysfunction rate was 10% and the rate of urinary incontinence was 3% according to meta-analysis of 9 and 8 studies respectively. Only two studies in this group reported patient satisfaction rate (92% and 74%).