Urethral Structure Length ≥ 2 cm is Significantly Associated with Lower Urethroplasty Success Rate, Results of our Large Case Series
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2018, Vol 9, Issue 5
Abstract
Urethral stricture is a relatively common disease in men and remains a reconstructive difficulty for urologists. It is associated with an unequivocal negative impact on the quality of life. The etiology is variable and the incidence is increasing in recent years with more frequent application of endoscopic instruments and indwelling catheters. Some of the most common etiologies of stricture disease include lichen sclerosis (LS), trauma, iatrogenesis, and infection [1-2]. Urethroplasty is considered the gold standard treatment for definitive correction of the disease reaching a success rate of 90%. Most of these strictures are short enough to make end-to-end urethral opposition. Normally, grafts are used when the strictures are too long or when patient already underwent a previously failed reconstruction attempt. The buccal mucosa is the most commonly used graft source [3]. The aim of this study was to investigate the correlation between urethral stricture etiology and length with the success rate in a large double-center series using the same surgical technique.We retrospectively collected the data of448 consecutive patients affected by urethral stricture who received surgery at University of Southern California of Los Angeles (USC) and University of Rome (UCBM) from 1998 to 2014. Patients were categorized based on the length of stricture in three different groups: group A 1-1.9 cm; group B 2-3cm and group C >3.1 cm. Urethral stricture etitologies and features (site and length) are showed in Table 1. Patients underwent urethroplasty according to the same technique. We performed end-to-end anastomosis for stricture <2cm (group A) and ventral buccal mucosa graft urethroplasty for patients with stricture >2cm (groups B and C). Comparative outcomes between the groups (by lenght) were assessed using analysis of a chi- square test. A logistic regression was used to calculate the odd ratio of success compared to the length. Statistical analysis was performed using STATA version 14.0 with 0.05 set as the level of significance. Database was analyzed to understand the impact of different urethral stricture lengths and etiologies on success rates. We collected data about one-year follow-up. All patients underwent urethral-cystoscopy and flowmetry at 1-6-12 month. Success was set as absence of urinary flow obstruction (no sign of endoscopic stricture and Q max > 10 ml/sec).
Authors and Affiliations
Cristina Falavolti, Roberto Giulianelli, Ervin Shehu, Pouria Alijani, Riccardo Giovannone, Tommasangelo Petitti, Stuart F Boyd, Maurizio Buscarini
Keywords
Related Articles
- EP ID EP591820
- DOI 10.26717/BJSTR.2018.09.001854
- Views 182
- Downloads 0
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