Results of urethral reconstruction in neglected urethral foreign bodies with associated urethral strictures

Abstract

Objective:

Urethral foreign bodies with associated urethral strictures are unusual entities. Although few case studies have reported the management of urethral foreign bodies, the management of neglected foreign bodies with resultant urethral strictures has not been addressed in the literature.

Materials and Methods:

A retrospective review of 15 patients diagnosed with strictures and associated urethral foreign bodies was performed for collection of data, viz., demographic and clinicopathological factors; details of urethral reconstruction procedures; perioperative and postoperative events; and follow-up data.

Results:

Underlying aetiology was self-insertion for sexual gratification in nine patients (metallic safety pins – 3, wooden splinters – 2, electric cables – 2, and plastic rods in two patients), gunshot injuries with embedded pellets in 4, and iatrogenic foreign bodies in two patients. Three patients had complete urethral obstruction, six had bulbar strictures, four had penile urethral strictures, and two had pan urethral strictures. Seven strictures were managed by primary end-to-end anastomosis, three by augmented roof-strip anastomosis using oral mucosal grafts, while the remaining five patients required augmentation urethroplasty using oral mucosal grafts. The overall success rate of urethral reconstruction was 93.3%.

Conclusion:

Neglected urethral foreign bodies with associated urethral strictures are uncommon. Surgical management, although challenging owing to an unhealthy local milieu, has satisfactory outcomes.

Level of Evidence:

Not applicable.