#0657

Comparative Analysis of Graft Options for Urethral Stricture: Implications for Qmax, Erectile Dysfunction, and Quality of Life: A Systematic Review and Meta Analysis

a. soeroto¹, C. Sampetoding²

¹Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Departemen Of Urology, Jakarta, Indonesia
²Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Departement Of Urology, Jakarta, Indonesia

Introduction:

Urethral strictures, caused by fibrotic narrowing of the urethral lumen, lead to micturition dysfunction and remain a significant urological challenge. They can result from trauma, idiopathic factors, or infections, with trauma being the leading cause, accounting for 58% of cases. Common traumatic causes include catheter-related injuries and traffic accidents. To restore urethral patency , various grafting techniques are available for urethral stricture reconstruction.

Material and methods:

A systematic review and meta-analysis were performed according to PRISMA guidelines, identifying studies on urethral stricture management using various grafts (buccal, preputial, and labial) with outcomes including Qmax, IIEF, and IPSS.

Results:

Nine studies were included. Overall, graft-based reconstruction significantly improved Qmax (MD: 15.29 mL/sec; 95% CI: 14.83–15.75 [fixed-effects]; 15.25 mL/sec; 95% CI: 12.82–17.68 [random-effects]) with sustained improvements up to 12 months, despite high heterogeneity (I² = 95.0%, p < 0.0001). Subgroup analysis revealed similar efficacy between buccal and preputial grafts, with a significant reduction in IPSS (MD: -12.30; 95% CI: -12.80 to -11.79, I² = 0%). In contrast, IIEF scores showed no significant postoperative change (MD: -0.69; 95% CI: -1.60 to 0.22, I² = 86.9%).