Short-term outcome and morbidity of different contemporary urethroplasty techniques--a preliminary comparison
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Short-term outcome and morbidity of different contemporary urethroplasty techniques--a preliminary comparison. / Kluth, Luis A; Dahlem, Roland; Reiß, Christoph-Philip; Pfalzgraf, Daniel; Becker, Andreas; Engel, Oliver; Chun, Felix K-H; Fisch, Margit; Ahyai, Sascha A.
In: J ENDOUROL, Vol. 27, No. 7, 01.07.2013, p. 925-9.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Short-term outcome and morbidity of different contemporary urethroplasty techniques--a preliminary comparison
AU - Kluth, Luis A
AU - Dahlem, Roland
AU - Reiß, Christoph-Philip
AU - Pfalzgraf, Daniel
AU - Becker, Andreas
AU - Engel, Oliver
AU - Chun, Felix K-H
AU - Fisch, Margit
AU - Ahyai, Sascha A
PY - 2013/7/1
Y1 - 2013/7/1
N2 - BACKGROUND AND PURPOSE: Only few comparative reports about different urethroplasties have been published, addressing success rate (SR), adverse events (AE), and quality of life (QoL). Our purpose was to evaluate SR, AE, and QoL in a contemporary cohort of patients undergoing urethroplasty in the short-term follow-up (FU).PATIENTS AND METHODS: Between December 2008 and June 2010, 205 patients underwent urethroplasty for anterior urethral strictures at our institution. A standardized questionnaire was sent to all patients. The primary end point was SR. Secondary end points were AE and QoL. To assess the risk of SR, the Kaplan-Meier method and log-rank test were used. To assess risk factors for urethral stricture recurrence (SRec), univariable Cox regression analysis was used.RESULTS: Overall, 140 (68%) patients responded to our questionnaire and were used for analysis. Of these 9%, 85%, and 6% were treated by excision and primary anastomosis (EPA), buccal mucosa graft urethroplasty (BMGU), and mesh graft urethroplasty (MGU), respectively. At 10 months of FU, SR was 87.5%. SRs of EPA, BMGU, and MGU were 100% (n=13/13), 85.7% (n=102/119), and 87.5% (n=7/8), with no significant differences between the groups. In univariable analysis, ≥ 2 vs 1 previous urethroplasties showed a trend toward a reduced SR (hazard risk 2.95; P=0.057). Streaking the urethra (P=0.024) and penile curvature (P=0.026) were significantly more often associated with MGU compared with EPA and BMGU. Postoperative total median (mean) scores were 3.5 (4.8) for the International Consultation on Incontinence Questionnaire Male lower urinary tract symptoms, 15 (15.2) for the International Index of Erectile Function, and 80 (73) for EuroQol visual analogue score; there was no difference between urethroplasty types.CONCLUSION: In the short-term FU, urethroplasty demonstrates an excellent SR. Specific SRs of EPA, BMGU, and MGU seem comparable. Despite significant differences in AE, patient reported QoL is high with no difference between the applied techniques.
AB - BACKGROUND AND PURPOSE: Only few comparative reports about different urethroplasties have been published, addressing success rate (SR), adverse events (AE), and quality of life (QoL). Our purpose was to evaluate SR, AE, and QoL in a contemporary cohort of patients undergoing urethroplasty in the short-term follow-up (FU).PATIENTS AND METHODS: Between December 2008 and June 2010, 205 patients underwent urethroplasty for anterior urethral strictures at our institution. A standardized questionnaire was sent to all patients. The primary end point was SR. Secondary end points were AE and QoL. To assess the risk of SR, the Kaplan-Meier method and log-rank test were used. To assess risk factors for urethral stricture recurrence (SRec), univariable Cox regression analysis was used.RESULTS: Overall, 140 (68%) patients responded to our questionnaire and were used for analysis. Of these 9%, 85%, and 6% were treated by excision and primary anastomosis (EPA), buccal mucosa graft urethroplasty (BMGU), and mesh graft urethroplasty (MGU), respectively. At 10 months of FU, SR was 87.5%. SRs of EPA, BMGU, and MGU were 100% (n=13/13), 85.7% (n=102/119), and 87.5% (n=7/8), with no significant differences between the groups. In univariable analysis, ≥ 2 vs 1 previous urethroplasties showed a trend toward a reduced SR (hazard risk 2.95; P=0.057). Streaking the urethra (P=0.024) and penile curvature (P=0.026) were significantly more often associated with MGU compared with EPA and BMGU. Postoperative total median (mean) scores were 3.5 (4.8) for the International Consultation on Incontinence Questionnaire Male lower urinary tract symptoms, 15 (15.2) for the International Index of Erectile Function, and 80 (73) for EuroQol visual analogue score; there was no difference between urethroplasty types.CONCLUSION: In the short-term FU, urethroplasty demonstrates an excellent SR. Specific SRs of EPA, BMGU, and MGU seem comparable. Despite significant differences in AE, patient reported QoL is high with no difference between the applied techniques.
KW - Adolescent
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Morbidity
KW - Mouth Mucosa
KW - Postoperative Complications
KW - Quality of Life
KW - Questionnaires
KW - Reconstructive Surgical Procedures
KW - Recurrence
KW - Retrospective Studies
KW - Surgical Flaps
KW - Time Factors
KW - Treatment Outcome
KW - United States
KW - Urethra
KW - Urethral Stricture
KW - Urologic Surgical Procedures, Male
KW - Young Adult
U2 - 10.1089/end.2013.0029
DO - 10.1089/end.2013.0029
M3 - SCORING: Journal article
C2 - 23488676
VL - 27
SP - 925
EP - 929
JO - J ENDOUROL
JF - J ENDOUROL
SN - 0892-7790
IS - 7
ER -
