Advancing Intraoperative Assessment of Urethral Stricture Anatomic Variation
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Advancing Intraoperative Assessment of Urethral Stricture Anatomic Variation : a Prospective Proof-of-concept Study. / Marks, Phillip; Dahlem, Roland; Daniels, Peer; Klemm, Jakob; Kühnke, Lennart; Kranzbühler, Benedikt; König, Frederik; Ding, Liucheng; Engel, Oliver; Soave, Armin; Fisch, Margit; Vetterlein, Malte W.
In: UROL INT, Vol. 108, No. 3, 06.2024, p. 254-258.Research output: SCORING: Contribution to journal › Short publication › Research › peer-review
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TY - JOUR
T1 - Advancing Intraoperative Assessment of Urethral Stricture Anatomic Variation
T2 - a Prospective Proof-of-concept Study
AU - Marks, Phillip
AU - Dahlem, Roland
AU - Daniels, Peer
AU - Klemm, Jakob
AU - Kühnke, Lennart
AU - Kranzbühler, Benedikt
AU - König, Frederik
AU - Ding, Liucheng
AU - Engel, Oliver
AU - Soave, Armin
AU - Fisch, Margit
AU - Vetterlein, Malte W
N1 - Brief Report
PY - 2024/6
Y1 - 2024/6
N2 - INTRODUCTION: Urethral strictures, particularly those refractory to endoscopic interventions, are commonly treated through open urethroplasty. However, predicting recurrence in homogeneous patient populations remains challenging.METHODS: To address this, we developed an intraoperative urethral stricture assessment tool aiming to identify comprehensive risk predictors. The assessment includes detailed parameters on stricture location, length, urethral bed width, spongiosum thickness, obliteration grade, and spongiofibrosis extension. The tool was prospectively implemented in 106 men with anterior one-stage augmentation urethroplasty from April 2020 to October 2021.RESULTS: An intraoperative granular assessment of intricate stricture characteristics is feasible. Comparative analyses revealed significant differences between bulbar and penile strictures. Bulbar strictures exhibited wider urethral beds and thicker spongiosum compared to penile strictures (all p < 0.001). The assessment showed marked variations in the degree of obliteration and spongiofibrosis extension.CONCLUSION: Our tool aligns with efforts to standardize urethral surgery, providing insights into subtle disease intricacies and enabling comparisons between institutions. Notably, intraoperative assessment may surpass the limitations of preoperative imaging, emphasizing the necessity of intraoperative evaluation. While limitations include a single-institution study and limited sample size, future research aims to refine this tool and determine its impact on treatment strategies, potentially improving long-term outcomes for urethral strictures.
AB - INTRODUCTION: Urethral strictures, particularly those refractory to endoscopic interventions, are commonly treated through open urethroplasty. However, predicting recurrence in homogeneous patient populations remains challenging.METHODS: To address this, we developed an intraoperative urethral stricture assessment tool aiming to identify comprehensive risk predictors. The assessment includes detailed parameters on stricture location, length, urethral bed width, spongiosum thickness, obliteration grade, and spongiofibrosis extension. The tool was prospectively implemented in 106 men with anterior one-stage augmentation urethroplasty from April 2020 to October 2021.RESULTS: An intraoperative granular assessment of intricate stricture characteristics is feasible. Comparative analyses revealed significant differences between bulbar and penile strictures. Bulbar strictures exhibited wider urethral beds and thicker spongiosum compared to penile strictures (all p < 0.001). The assessment showed marked variations in the degree of obliteration and spongiofibrosis extension.CONCLUSION: Our tool aligns with efforts to standardize urethral surgery, providing insights into subtle disease intricacies and enabling comparisons between institutions. Notably, intraoperative assessment may surpass the limitations of preoperative imaging, emphasizing the necessity of intraoperative evaluation. While limitations include a single-institution study and limited sample size, future research aims to refine this tool and determine its impact on treatment strategies, potentially improving long-term outcomes for urethral strictures.
U2 - 10.1159/000536565
DO - 10.1159/000536565
M3 - Short publication
C2 - 38295776
VL - 108
SP - 254
EP - 258
JO - UROL INT
JF - UROL INT
SN - 0042-1138
IS - 3
ER -