RESUMO
OBJECTIVES: To determine the long-term outcome and complications of non-transecting anastomotic bulbar urethroplasty for the treatment of small bulbar urethral strictures presenting at Liaquat National Hospital, Karachi. METHODS: This interventional study was conducted from January 2012 to December 2019 with the study duration of eight year at Liaquat National Hospital, Karachi. All patients presenting in the outpatient department with urethral strictures were included in the study. Patients were evaluated postoperatively for complications and outcomes were determined. The data was analyzed using SPSS v.25. RESULTS: A total of 358 patients were treated with non-transecting anastomotic bulbar urethroplasty during this 8-years period. The most common site of stricture formation was bulbar urethra 186 (50%), followed by bulbo-membranous urethra; 103 (31%), and bulbo-penile urethra; 69 (19%). The mean stricture was 1.2 cm (0.5-2.5 cm) in length. The main postoperative complications were scrotal swelling in 7 (1.9%), wound infection in 6 (1.6%), wound dehiscence in 3 (0.8%), and transient sexual dysfunction in 31 (8.6%) patients with an overall initial success rate of 97.8%. No permanent deficit in sexual function was reported. CONCLUSIONS: Non-transecting anastomotic bulbar urethroplasty has a good outcome with insignificant postoperative complications in patients with small bulbar urethral stricture disease.
RESUMO
BACKGROUND: Urinary incontinence is an uncommon problem in males but has major impact on daily living. This study aimed to highlight the outcome of surgical treatment in terms of safety, efficacy and cost-effectiveness in the management of urinary incontinence.. METHODS: A Total of 48 patients, prospective experimental study, in the duration of 4 years conducted at Department of Urology, Liaquat National Hospital & Medical College. Patients having moderate to severe urinary incontinence for 1 year after transurethral resection of prostate, radical prostatectomy, road traffic accident with pelvic fracture causing neurologic damage were included in this study. Patients having mild incontinence, having multiple co-morbid conditions were excluded from this study. Outcome of surgery was noted during follow up visit after 13 month (median). The data was obtained and analysed by using SPSS version 20. Mean and standard deviation for quantitative data, frequency and percentage for categorical variables were presented. RESULTS: Out of 48 patients having urinary incontinence, 28 (58.3%) had severe urinary incontinence while 20 (41.7%) had moderate incontinence. After surgery, 28 (58.3%) patient had no leakage all day, 12 (25%) had some leakage while bending and 8 (16.7%) had no improvement in symptoms. On ultrasound recorded after voiding in post-surgery patients, 40 (83.3%) had no residual found in bladder while 8(16.7%) could not be assessed due to persistence of urinary incontinence. CONCLUSIONS: Our study predicted that in patients having moderate to severe urinary incontinence, Prolene Mesh repair anchoring with Prolene suture can be an efficient and costeffective treatment for the urinary incontinence with least complications.
