Everted Saphenous Vein Graft (eSVG) urethroplasty in long-segment anterior urethral strictures: Medium-term follow-up results

Abstract

Purpose: An everted saphenous vein graft (eSVG) has been used for urethroplasty in men with long segment anterior urethral stricture and chronic tobacco exposed oral mucosa with good initial results. The present study aimed to assess the medium-term outcomes of eSVG urethroplasty (eSVGU) in such patients. Materials and Methods: Prospectively maintained database of 32 patients with chronic tobacco exposed oral mucosa, who underwent an eSVGU for long segment anterior urethral stricture (≥9 cm), was reviewed. Outcomes were assessed with International Prostate Symptom Score (IPSS), uroflowmetry with postvoid residual urine at 1, 3, and 6 months, and thereafter 6 monthly symptomatic assessments. Retrograde urethrogram was done at 3 months and repeated only if there was a recurrence. Successful urethroplasty was defined as satisfactory voiding (maximum flow rate [Qmax] >15 ml/sec) and no need for any auxiliary procedures in follow-up. Patients who lost to follow-up before 3 years were excluded from the final analysis. Data from the patients were recorded on a spreadsheet and expressed as mean and standard deviation wherever feasible. Results: Mean stricture length was 13.75 cm. Two patients were lost to follow-up after 12 months and were excluded from the final analysis. At a mean follow-up of 58 months, 19 patients (63.33%) were voiding successfully with mean IPSS 8.15 and Qmax 23.54 ml/s respectively, while 11 patients (36.67%) required auxiliary procedures and were considered failed. Conclusion: Medium-term results suggest that an eSVG can be considered as a good alternative graft for urethroplasty in patients with long anterior urethral strictures.