Journal article
Development and Validation of A Male Anterior Urethral Stricture Classification System
Urology (Ridgewood, N.J.), Vol.143, pp.241-247
09/2020
DOI: 10.1016/j.urology.2020.03.072
PMID: 32580016
Abstract
To develop and validate a clinical classification system for urethral stricture disease (USD) based on the retrograde urethrogram (RUG), physical exam, and stricture-specific patient history.
Three elements were chosen to be included in the classification system: 1) Length of urethral stricture (L); 2) Stricture segment/location (S); 3) Stricture Etiology (E) (LSE classification system). Each element was divided into clinically relevant sub-categories. A three-step development and validation process then ensued, culminating in an in-person Trauma and Urologic Reconstruction Network of Surgeons (TURNS) meeting, at which the final classification system was unanimously agreed upon by attendees based on interrater reliability data obtained from the classifying of 22 clinical vignettes. A final validation step involved retrospectively classifying cases in the TURNS database to determine if classification influenced surgical technique and was associated with presumed stricture etiology.
The final LSE classification system was found to have an interrater reliability of 0.79 (individual components 0.76, 0.70 and 0.93 respectfully). Retrospective classification of the 2162 TURNS strictures revealed the segment (S) to be strongly associated with urethroplasty type (p = 0.0005) and stricture etiology (E) (p = 0.0005).
We developed and validated a novel, easy to use, urethral stricture classification system. The system's ability to aid in directing treatments, predict treatment outcomes, and facilitate collaborative research efforts will require further study.
Details
- Title: Subtitle
- Development and Validation of A Male Anterior Urethral Stricture Classification System
- Creators
- Bradley A Erickson - University of Iowa, Department of Urology, Iowa City, IA. Electronic address: brad-erickson@uiowa.edu.Kevin J Flynn - University of IowaAmy E Hahn - University of IowaKatherine Cotter - University of IowaNejd F Alsikafi - Uropartners, Gurnee, IL.Benjamin N Breyer - University of California, San FranciscoJoshua A Broghammer - University of KansasJill C Buckley - University of California, San DiegoSean P Elliott - University of MinnesotaJeremy B Myers - University of UtahAndrew C Peterson - Duke UniversityKeith F Rourke - University of AlbertaThomas G Smith III - MD Anderson Cancer Center, Department of Urology Houston, TXAlex J Vanni - Lahey Hospital and Medical CenterBryan B Voelzke - Spokane Urology, Spokane, WALee C Zhao - New York UniversityTrauma and Urologic Reconstruction Network of Surgeons (TURNS)
- Resource Type
- Journal article
- Publication Details
- Urology (Ridgewood, N.J.), Vol.143, pp.241-247
- DOI
- 10.1016/j.urology.2020.03.072
- PMID
- 32580016
- ISSN
- 0090-4295
- eISSN
- 1527-9995
- Language
- English
- Date published
- 09/2020
- Academic Unit
- Urology
- Record Identifier
- 9984320062802771
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