Safety and Surgical Outcomes of Same-day Anterior Urethroplasty

Objective To evaluate the safety and feasibility of same-day anterior urethroplasty at our institution and define predictors of postoperative admission and surgical failure. Methods We retrospectively reviewed the charts of 118 consecutive anterior urethroplasties performed at a tertiary care center. Data were analyzed to detect predictors of postoperative admission and urethroplasty failure. The 30-day complications and long-term outcomes were compared between same-day and admitted patients. Results Ninety-two patients (78%) were discharged on the day of surgery. A penile stricture location compared with a bulbar stricture location (odds ratio: 13.4, P  = .009) and having undergone more than 3 prior endoscopic stricture interventions (odds ratio: 10.2, P  = .001) were significantly associated with postoperative admission. Patients with a ventral onlay approach were more likely to be discharged home ( P  = .03), whereas patients with combined repairs were more likely to be admitted ( P  = .04). Same-day urethroplasty did not increase 30-day postoperative complications, patient emergency room visits, unplanned clinic visits, or phone calls. Success rates did not differ between same-day (89%) and admitted (79%) cohorts, and no individual stricture characteristic was predictive of urethroplasty failure. Conclusion Same-day anterior urethroplasty is safe and feasible and could help increase utilization of urethroplasty for urethral stricture disease.