Urethroplasty for Urethral Stenosis

Seung-Kwon ChoiKorea (Republic of) Speaker Urethroplasty for Urethral StenosisUrethroplasty is a definitive treatment for urethral stricture disease. Despite its high success rate, surgical site infections (SSIs) and urinary tract infections (UTIs) remain notable postoperative complications. Antibiotic prophylaxis practices vary significantly among reconstructive urologists, ranging from single-dose perioperative regimens to prolonged courses until catheter removal. However, there is limited high-quality evidence to guide optimal antibiotic duration in this context. Recent prospective cohort studies demonstrated no significant reduction in UTI or wound infection with extended antibiotic prophylaxis versus limited regimens. Moreover, prolonged antibiotic use was associated with a significantly higher incidence of multidrug-resistant (MDR) organisms. Additional studies confirmed the lack of correlation between bacteriuria and stricture recurrence or wound complications. Prolonged postoperative antibiotic prophylaxis offers no clear benefit in preventing SSIs or UTIs following urethroplasty. In contrast, it may promote the development of MDR organisms. Current evidence support a practice shift toward single-dose perioperative antibiotics. These strategies enhance antibiotic stewardship while maintaining clinical safety.