Outcomes of Ventral Onlay Buccal Mucosa Graft Urethroplasty in Patients after Radiotherapy
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Outcomes of Ventral Onlay Buccal Mucosa Graft Urethroplasty in Patients after Radiotherapy. / Ahyai, Sascha A; Schmid, Marianne; Kuhl, Marie; Kluth, Luis A; Soave, Armin; Riechardt, Silke; Chun, Felix K-H; Engel, Oliver; Fisch, Margit; Dahlem, Roland.
in: J UROLOGY, Jahrgang 194, Nr. 2, 08.2015, S. 441-6.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Outcomes of Ventral Onlay Buccal Mucosa Graft Urethroplasty in Patients after Radiotherapy
AU - Ahyai, Sascha A
AU - Schmid, Marianne
AU - Kuhl, Marie
AU - Kluth, Luis A
AU - Soave, Armin
AU - Riechardt, Silke
AU - Chun, Felix K-H
AU - Engel, Oliver
AU - Fisch, Margit
AU - Dahlem, Roland
N1 - Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
PY - 2015/8
Y1 - 2015/8
N2 - PURPOSE: We evaluated stricture-free survival and functional outcomes of buccal mucosa graft urethroplasty in patients with urethral stricture disease after radiotherapy.MATERIALS AND METHODS: We reviewed our urethroplasty database for patients with a radiotherapy history who underwent buccal mucosa graft urethroplasty between January 2009 and October 2013. We reviewed patient charts and the institutional, standardized, nonvalidated questionnaires administered to each patient postoperatively. Study end points included 1) the success rate, 2) continence status, 3) erectile function and 4) patient satisfaction postoperatively. Success was defined as stricture-free survival.RESULTS: Of 38 men included in the study prostate cancer was the most common indication for radiotherapy in 35 (92.1%). External beam radiotherapy was performed in 24 cases (64.9%), brachytherapy was done in 8 (21.6%) and a combination of the 2 treatments was performed in 6 (13.5%). Strictures were in the bulbar/bulbomembranous urethra and had a median length of 3.0 cm (range 1.0 to 8.0). The overall success rate was 71.1% at a median followup of 26.5 months (range 1.0 to 50.0). Median time to stricture recurrence was 17.0 months (range 3.0 to 44.0). De novo urinary incontinence was observed in 4 patients (10.5%). Erectile function remained mostly unchanged compared to preoperative status. Study limitations include the small sample size and the lack of validated questionnaires.CONCLUSIONS: At short-term to mid-term followup the success rate of ventral onlay buccal mucosa graft urethroplasty in patients with radiotherapy history seems acceptable. However, patients must be counseled about the increased risk of urinary incontinence. Longer followup is warranted to address long-term outcomes.
AB - PURPOSE: We evaluated stricture-free survival and functional outcomes of buccal mucosa graft urethroplasty in patients with urethral stricture disease after radiotherapy.MATERIALS AND METHODS: We reviewed our urethroplasty database for patients with a radiotherapy history who underwent buccal mucosa graft urethroplasty between January 2009 and October 2013. We reviewed patient charts and the institutional, standardized, nonvalidated questionnaires administered to each patient postoperatively. Study end points included 1) the success rate, 2) continence status, 3) erectile function and 4) patient satisfaction postoperatively. Success was defined as stricture-free survival.RESULTS: Of 38 men included in the study prostate cancer was the most common indication for radiotherapy in 35 (92.1%). External beam radiotherapy was performed in 24 cases (64.9%), brachytherapy was done in 8 (21.6%) and a combination of the 2 treatments was performed in 6 (13.5%). Strictures were in the bulbar/bulbomembranous urethra and had a median length of 3.0 cm (range 1.0 to 8.0). The overall success rate was 71.1% at a median followup of 26.5 months (range 1.0 to 50.0). Median time to stricture recurrence was 17.0 months (range 3.0 to 44.0). De novo urinary incontinence was observed in 4 patients (10.5%). Erectile function remained mostly unchanged compared to preoperative status. Study limitations include the small sample size and the lack of validated questionnaires.CONCLUSIONS: At short-term to mid-term followup the success rate of ventral onlay buccal mucosa graft urethroplasty in patients with radiotherapy history seems acceptable. However, patients must be counseled about the increased risk of urinary incontinence. Longer followup is warranted to address long-term outcomes.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Disease-Free Survival
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Mouth Mucosa
KW - Prostatic Neoplasms
KW - Radiation Injuries
KW - Radiotherapy, Adjuvant
KW - Reconstructive Surgical Procedures
KW - Retrospective Studies
KW - Time Factors
KW - Treatment Outcome
KW - Urethra
KW - Urethral Stricture
KW - Urologic Surgical Procedures, Male
U2 - 10.1016/j.juro.2015.03.116
DO - 10.1016/j.juro.2015.03.116
M3 - SCORING: Journal article
C2 - 25846417
VL - 194
SP - 441
EP - 446
JO - J UROLOGY
JF - J UROLOGY
SN - 0022-5347
IS - 2
ER -