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PD11-13 PATIENT CHARACTERISTICS AND OUTCOMES OF URETHRAL LIGATION: A TURNS COHORT STUDY
Abstract   Peer reviewed

PD11-13 PATIENT CHARACTERISTICS AND OUTCOMES OF URETHRAL LIGATION: A TURNS COHORT STUDY

Behzad Abbasi, Anna Farris, Keith F. Rourke, Lee C. Zhao, Andrew J. Cohen, Thomas G. Smith, Sean P. Elliott, Joshua A. Broghammer, Bradley A. Erickson, John M. Myrga, …
The Journal of urology, Vol.215(5S), p.e638
05/2026
DOI: 10.1097/01.JU.0001191452.55243.54.13

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Abstract

INTRODUCTION AND OBJECTIVES: To profile candidate characteristics and evaluate midterm outcomes following urethral ligation for diverse indications in a multicenter cohort. METHODS: A retrospective review of patients undergoing urethral ligation in the Trauma and Urologic Reconstructive Network of Surgeons (TURNS) database was performed. Failure rates were determined as the recurrence of incontinence. Kaplan-Meier curves were used to determine the risk of failure and complications. RESULTS: We identified 27 men with urethral ligation (median age 72 years, IQR 48–81). Indications included refractory incontinence in 12 (44.4%), artificial urinary sphincter (AUS) cuff erosion in 9 (33.3%), recalcitrant stricture in 4 (14.8%), and non-AUS–related urethral erosion in 2 (7.4%). Neurogenic bladder was present in 7 (25.9%) cases, and history of prior pelvic radiation and internal urethral trauma in 8 (29.6%) and 5 (18.5%), respectively. Prior treatments included, urethroplasty in 6 (22.2%), urethral dilation in 5 (18.5%), and urethrotomy in 2 (7.4%). 9 (33.3%) patients were maintained on intermittent catheterization. A gracilis flap was used in 5 (18.5%). Suprapubic diversion was performed in 19 (70.4%), with continent and incontinent catheter channels in 7 (25.9%) and 1 (3.7%), respectively. Median follow-up was 24 months (IQR 4–48). Adjunctive therapies included anticholinergics in 12 (44.4%), intravesical botulinum in 11 (40.7%), and β3 agonists in 7 (25.9%). Thirty-day readmission occurred in 5 (18.5%). The 4-year cumulative risks of failure and revision were 11.6% (95% CI 3.9–32.9) and 3.7% (95% CI 0.53–23.5), respectively. Of 16 patients followed ≥1 year, 9 (56%) developed a urinary tract infection (median 1 episode, IQR 0–3), and 3 (18.8%) developed urethral fistula. CONCLUSIONS: In a multi-institutional cohort, urethral ligation achieved high midterm success with low risk of revision surgery or fistulation. Infection risk, readmission burden, and frequent need for adjunctive therapies highlight the need for structured postoperative surveillance and bladder-directed interventions.

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