Is it necessary to use a drain after urethroplastyby perineal approach if we can avoid complications by pressure dressing?

Objective: Peri-operative management of urethroplasty is yet to be standardized. One of the major obscure issues in perioperative management is the use of perineal drainage. Some reconstructive urologists prefer to use a drain as a routine while others never use one. Although the main purpose of drain placement is to prevent the collection and related wound complications, no study up-to-date refers to these complications neither with nor without drain usage.

Methods: 152 consecutive patients who underwent urethroplastyvia perineal approach without perineal drain were included. Strict pressure dressing was applied to all patients. The presence of any perineal fluid collection, wound related complications and the need for re-operation for these complications were recorded.

Results: Despite 42% of patients having a smoking history and other potential risk factors for wound related complications, there were no instances of fluid collection or wound dehiscence post-operatively.

Conclusions: Given the absolute absence of drainage related complications by applying only pressure dressing, we suggest that a perineal drain is not necessary after urethroplasty via perineal approach. Applying pressure dressing is an effective method to prevent fluid collection and related morbidities.