To the editor,

We appreciate the editorial comments on our manuscript (¹1 Lu K, Chen Y, Hu H. Re: Long term outcomes of one-stage augmentation anterior urethroplasty: a systematic review and meta-analysis. Int Braz J Urol. 2023;49:163-4., ²2 Benson CR, Li G, Brandes SB. Long term outcomes of onestage augmentation anterior urethroplasty: a systematic review and meta-analysis. Int Braz J Urol. 2021;47:237-50.). Unfortunately, the reconstructive urology urethroplasty literature is almost all retrospective and cohort sizes are relatively small. Moreover, only a few papers report interim or long-term follow up success. It is because of the very limitations and weaknesses of the urethroplasty literature that we needed to perform a systematic review and meta-analysis. We closely followed the PRISMA method here and understand the critique of not utilizing the Newcastle-Ottawa Scale to assess the studies. The main take home of our analysis is that the “85% success rate” that is often quoted preoperatively to patients appears to be a clear over -estimation of the success of augmentation urethroplasty. Despite the inherent limitations of the literature, our manuscript clearly shows that augmentation urethroplasty has a slow and progressive recurrence rate overtime. The longer the follow up the more recurrences are identified. Augmentation urethroplasty demonstrates good success at intermediate follow-up, but with longer follow up it appears that it is not the panacea that it is commonly thought.

The authors.

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