Login to Access Video or Poster Abstract: MP36-13
Sources of Funding: None

Introduction

We evaluated changes in nocturnal voiding patterns of men before and after anterior urethroplasty for urethral stricture disease using a pre-operative and post-operative 24 hour bladder diary.

Methods

This was a retrospective study of men undergoing anterior urethroplasty for urethral stricture who completed a pre-operative and post-operative 24 hour bladder diary. Diaries done anytime prior to surgery and at least 1 month after surgery were included. Patients recorded the volume, time of void and degree of urgency of voids. Paired t-tests were performed on nocturnal voiding variables.

Results

18 men had preoperative and post-operative 24 hour bladder diaries. The mean age was 45.4 years (median 46.5,range, 26-70). 13 strictures were bulbar (72.2%), 4 pendulous-bulbar (22.2%), and 1 in the penile urethra (5.6%). Type of surgery included 6 (33%) buccal mucosa onlay grafts (5 dorsal, 1 ventral), augmented anastomotic repair, (n=2, 11.1%), and excision and primary anastomosis (n=10, 55.6%). Mean days from surgery to first post-operative 24 hour bladder diary was 287.5 days (median 109, range, 32-1116). _x000D_ Maximum voided volume increased after surgery (p = 0.02). _x000D_ Overall, nocturnal voiding parameters improved after urethroplasty and trended towards significance primarily by increases in functional bladder capacity measured by the maximum voided volume (mean preop 333ml, post-op 406.6, p=0.02), number of nightly voids (mean 1.8 to 1.2, p=0.07), and the nocturnal bladder capacity index (mean 1.2 to 0.8, p=0.13) and the correlation of the degree of urgency with the voided volume (Spearman's rho mean 0.5 to 0.6, p=0.09). Urethroplasty did not improve nocturnal voiding parameters by changes in urine production as measured by changes in the 24 hour voided volume, nocturnal urine volume, the nocturnal urine production rate or the nocturnal polyuria index. _x000D_ _x000D_

Conclusions

Anterior urethral reconstruction improves nocturnal voiding parameters by improving functional bladder capacity. The maximum voided volume, actual night time voids, nocturnal bladder capacity index and Spearman's rho most significantly improved. This is the first study evaluating changes in nocturnal voiding function after urethroplasty.

Funding

None