Journal article
Multicenter urethroplasty outcomes for urethral stricture disease for patients with neurogenic bladder or bladder dysfunction requiring clean intermittent catheterization
Translational andrology and urology, Vol.10(5), pp.2035-2042
05/01/2021
DOI: 10.21037/tau-20-988
PMCID: PMC8185657
PMID: 34159084
Abstract
Background: Our objective is to better comprehend treatment considerations for urethral stricture disease (USD) in patients requiring long-term clean intermittent catheterization (CIC). Patient characteristics, surgical outcomes and complications are unknown in this population.
Methods: Six members of the Trauma and Urologic Reconstruction Network of Surgeons (TURNS) participated in a prospective (2009 to present) and retrospective (prior to 2009) database recording patient demographics, surgical approach and outcomes. We included all patients undergoing urethroplasty who perform CIC. Descriptive statistics were used to analyze results.
Results: A total of 37 patients with 39 strictures were included. Bladder dysfunction was characterized as detrusor failure in 35% and neurogenic etiology in 65%. Median stricture length was 3 cm (IQR: 1.5-5.5) with 28% repaired with dorsal onlay buccal mucosal graft, 26% excision and primary anastomosis, 8% dorsal inlay, 8% ventral and dorsal, 8% flap based 8% non-transacting and 15% other. Functional success was 90%: 4 patients required DVIU or dilation due to recurrence, with 2 of those ultimately requiring repeat urethroplasty. 86% of patients returned to CIC; no patients reported new pad use for urinary leakage after urethroplasty. During a median follow-up period of 3.1 years (IQR: 1.0-5.3), no patients underwent urinary diversion.
Conclusions: Urethroplasty is suitable, safe and effective for patients dependent on CIC suffering from USD. The effect of continual CIC on long-term outcomes remains uncertain.
Details
- Title: Subtitle
- Multicenter urethroplasty outcomes for urethral stricture disease for patients with neurogenic bladder or bladder dysfunction requiring clean intermittent catheterization
- Creators
- Andrew J. Cohen - Johns Hopkins HospitalPhilip J. Cheng - University of UtahSikai Song - San Francisco General HospitalGerman Patino - University of California, San FranciscoJeremy B. Myers - University of UtahSamit S. Roy - University of MinnesotaSean P. Elliott - University of MinnesotaJoseph Pariser - University of MinnesotaJustin Drobish - University of IowaBrad A. Erickson - University of IowaThomas W. Fuller - University of California San DiegoJill C. Buckley - University of California San DiegoAlex J. Vanni - Lahey Hospital and Medical CenterNima Baradaran - Department of Urology, Ohio State, Columbus, OH, USA.Benjamin N. Breyer - San Francisco General Hospital
- Resource Type
- Journal article
- Publication Details
- Translational andrology and urology, Vol.10(5), pp.2035-2042
- DOI
- 10.21037/tau-20-988
- PMID
- 34159084
- PMCID
- PMC8185657
- NLM abbreviation
- Transl Androl Urol
- ISSN
- 2223-4683
- eISSN
- 2223-4691
- Publisher
- Ame Publ Co
- Number of pages
- 8
- Grant note
- 10001 / Alafi Foundation
- Language
- English
- Date published
- 05/01/2021
- Academic Unit
- Urology
- Record Identifier
- 9984320073002771
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