Journal article
Defining Success after Anterior Urethroplasty: An Argument for a Universal Definition and Surveillance Protocol
The Journal of urology, Vol.208(1), pp.135-143
07/2022
DOI: 10.1097/JU.0000000000002501
PMID: 35239415
Abstract
A successful urethroplasty has been defined in different ways across studies. This variety in the literature makes it difficult to compare success rates and techniques across studies. We aim to evaluate the success of anterior urethroplasty based on different definitions of success in a single cohort.
Data were collected from a multi-institutional, prospectively maintained database. We included men undergoing first-time, single-stage, anterior urethroplasty between 2006 and 2020. Exclusion criteria included lack of followup, hypospadias, extended meatotomy, perineal urethrostomy, posterior urethroplasty and staged repairs. We compared 5 different ways to define a "failed" urethroplasty: 1) stricture retreatment, 2) anatomical recurrence on cystoscopy, 3) peak flow rate <15 ml/second, 4) weak stream on questionnaire and 5) failure by any of these measures. Kaplan-Meier survival curves were generated for each of the definitions. We also compared outcomes by stricture length, location and etiology.
A total of 712 men met inclusion criteria, including completion of all types of followup. The 1- and 5-year estimated probabilities of success were "retreatment," 94% and 75%; "cystoscopy," 88% and 71%; "uroflow," 84% and 58%; "questionnaire," 67% and 37%; and "any failure," 57% and 23%. This pattern was inconsistent across stricture length, location and etiology.
The estimated probability of success after first-time, anterior urethroplasty is highly dependent on the way success is defined. The variability in definitions in the literature has limited our ability to compare urethroplasty outcomes across studies.
Details
- Title: Subtitle
- Defining Success after Anterior Urethroplasty: An Argument for a Universal Definition and Surveillance Protocol
- Creators
- Katherine T Anderson - Department of Urology, Mayo Clinic, Rochester, MinnesotaAlex J Vanni - Lahey Hospital and Medical CenterBradley A Erickson - University of IowaJeremy B Myers - University of UtahBryan Voelzke - Spokane Urology, Spokane, WashingtonBenjamin N Breyer - University of California, San FranciscoJoshua A Broghammer - University of KansasJill C Buckley - University of California San DiegoLee C Zhao - NYU Langone HealthThomas G Smith III - Department of Urology, MD Anderson Cancer Center, Houston, TexasNejd F Alsikafi - Uropartners of Chicago, Chicago, IllinoisKeith F Rourke - University of AlbertaSean P Elliott - University of Minnesota System
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.208(1), pp.135-143
- DOI
- 10.1097/JU.0000000000002501
- PMID
- 35239415
- NLM abbreviation
- J Urol
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Language
- English
- Date published
- 07/2022
- Academic Unit
- Urology
- Record Identifier
- 9984319973202771
Metrics
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