Clinical significance of cystoscopic urethral stricture recurrence after anterior urethroplasty: a multi-institution analysis from Trauma and Urologic Reconstructive Network of Surgeons (TURNS)

Nima Baradaran; Kirkpatrick B Fergus; Rachel A Moses; Darshan P Patel; Thomas W Gaither; Bryan B Voelzke; Thomas G Smith III; Bradley A Erickson; Sean P Elliott; Nejd F Alsikafi; Alex J Vanni; Jill Buckley; Lee C Zhao; Jeremy B Myers; Benjamin N Breyer

doi:10.1007/s00345-019-02653-6

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Clinical significance of cystoscopic urethral stricture recurrence after anterior urethroplasty: a multi-institution analysis from Trauma and Urologic Reconstructive Network of Surgeons (TURNS)

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Clinical significance of cystoscopic urethral stricture recurrence after anterior urethroplasty: a multi-institution analysis from Trauma and Urologic Reconstructive Network of Surgeons (TURNS)

Nima Baradaran, Kirkpatrick B Fergus, Rachel A Moses, Darshan P Patel, Thomas W Gaither, Bryan B Voelzke, Thomas G Smith III, Bradley A Erickson, Sean P Elliott, Nejd F Alsikafi, …

World journal of urology, Vol.37(12), pp.2763-2768

12/2019

DOI: 10.1007/s00345-019-02653-6

PMID: 30712091

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Abstract

To assess the functional Queryoutcome of patients with cystoscopic recurrence of stricture post-urethroplasty and to evaluate the role of cystoscopy as initial screening tool to predict future failure. Cases with cystoscopy data after anterior urethroplasty in a multi-institutional database were retrospectively studied. Based on cystoscopic evaluation, performed within 3-months post-urethroplasty, patients were categorized as small-caliber (SC) stricture recurrence: stricture unable to be passed by standard cystoscope, large-caliber (LC) stricture accommodating a cystoscope, and no recurrence. We assessed the cumulative probability of intervention and the quality of life scores in association with cystoscopic recurrence 1-year post-urethroplasty. Patients with history of hypospadias, perineal urethrostomy, urethral fistula, and meatal pathology were excluded. From a total of 2630 men in our cohort, 1054 patients met the inclusion criteria: normal (n = 740), LC recurrence (n = 178), and SC recurrence (n = 136) based on the first cystoscopic evaluation performed at median 111 days postoperatively. Median follow-up was 350 days (IQR 121-617) after urethroplasty. Cystoscopic recurrence was significantly associated with secondary interventions (2.7%, 6.2%, 33.8% in normal, LC, and SC groups, respectively). Quality of life variables were not statistically significantly different among the three study groups. Many patients with cystoscopic recurrence do not need an intervention after initial urethroplasty. Despite good negative predictive value, cystoscopy alone may be a poor screening test for stricture recurrence defined by patient symptoms and need for secondary interventions.

Recurrence

Urethra - surgery

Urethral Stricture - surgery

Humans

Middle Aged

Urologic Surgical Procedures, Male - methods

Cystoscopy

Adult

Male

Retrospective Studies

Details

Title: Subtitle: Clinical significance of cystoscopic urethral stricture recurrence after anterior urethroplasty: a multi-institution analysis from Trauma and Urologic Reconstructive Network of Surgeons (TURNS)
Creators: Nima Baradaran - Department of Urology, Ohio State University, Columbus, OH, USA
Kirkpatrick B Fergus - Department of Urology, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, 1001 Potrero Suite 3A, San Francisco, CA, 94110, USA
Rachel A Moses - Division of Urology, University of Utah, Salt Lake City, UT, USA
Darshan P Patel - Division of Urology, University of Utah, Salt Lake City, UT, USA
Thomas W Gaither - Department of Urology, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, 1001 Potrero Suite 3A, San Francisco, CA, 94110, USA
Bryan B Voelzke - Department of Urology, University of Washington, Seattle, WA, USA
Thomas G Smith III - Department of Urology, Baylor College of Medicine, Houston, TX, USA
Bradley A Erickson - Department of Urology, University of Iowa, Iowa City, IA, USA
Sean P Elliott - Department of Urology, University of Minnesota, Minneapolis, MN, USA
Nejd F Alsikafi - Uropartners, Gurnee, IL, USA
Alex J Vanni - Department of Urology, Lahey Hospital and Medical Center, Burlington, MA, USA
Jill Buckley - Department of Urology, University of California San Diego, San Diego, CA, USA
Lee C Zhao - New York University School of Medicine, New York, NY, USA
Jeremy B Myers - Division of Urology, University of Utah, Salt Lake City, UT, USA
Benjamin N Breyer - Department of Urology, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, 1001 Potrero Suite 3A, San Francisco, CA, 94110, USA. benjamin.breyer@ucsf.edu
Resource Type: Journal article
Publication Details: World journal of urology, Vol.37(12), pp.2763-2768
DOI: 10.1007/s00345-019-02653-6
PMID: 30712091
NLM abbreviation: World J Urol
ISSN: 0724-4983
eISSN: 1433-8726
Publisher: Germany
Language: English
Date published: 12/2019
Academic Unit: Urology
Record Identifier: 9984051591802771

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