Journal article
Nontransecting Techniques Reduce Sexual Dysfunction after Anastomotic Bulbar Urethroplasty: Results of a Multi-Institutional Comparative Analysis
The Journal of urology, Vol.201(2), pp.364-370
02/2019
DOI: 10.1016/j.juro.2018.09.051
PMID: 30266331
Abstract
The purpose of this multi-institutional study was to compare outcomes of transecting and nontransecting anastomotic bulbar urethroplasty.
We performed a retrospective, multi-institutional review of the records of 352 patients who underwent transecting or nontransecting anastomotic bulbar urethroplasty performed by 1 of 4 reconstructive urologists from September 2003 to March 2017. Study outcomes were urethroplasty success, defined as urethral patency greater than 16Fr on cystoscopy; de novo sexual dysfunction assessed at 6 months, defined as a 5-point or greater change in the SHIM (Sexual Health Inventory for Men) or a patient reported adverse change; and 90-day complications, defined as Clavien 2 or greater. When appropriate, comparisons were made between the transecting and nontransecting cohorts using the Mantel-Cox test, the t-test or the chi-square test.
Of the 352 patients with a mean stricture length of 1.7 cm (range 0.5 to 5) 258 and 94 underwent transecting and nontransecting anastomotic bulbar urethroplasty, respectively. The overall success rate was 94.9% at a mean followup of 64.2 months (range 6 to 170). Of the patients 7.1% experienced a 90-day complication and 11.6% reported sexual dysfunction. When comparing transecting and nontransecting techniques, there was no difference in success (93.8% vs 97.9%, Mantel-Cox test p = 0.18) or postoperative complications (8.1% vs 4.3%, p = 0.25). Patients treated with transecting anastomotic urethroplasty were more likely to report an adverse change in sexual function (14.3% vs 4.3%, p = 0.008). On multivariate analysis only transecting urethroplasty was associated with sexual dysfunction (p = 0.01) while age (p = 0.29), stricture length (p = 0.42), etiology (p = 0.99) and surgeon (p = 0.88) were not.
Anastomotic urethroplasty is a highly effective surgery with relatively minimal associated morbidity. Nontransecting anastomotic urethroplasty compares quite favorably to the transecting technique and likely reduces the risk of associated sexual dysfunction.
Details
- Title: Subtitle
- Nontransecting Techniques Reduce Sexual Dysfunction after Anastomotic Bulbar Urethroplasty: Results of a Multi-Institutional Comparative Analysis
- Creators
- David W Chapman - Division of Urology, University of Alberta, Edmonton, Alberta, CanadaKatherine Cotter - Departments of Urology, University of Iowa, Iowa City, IowaNiels V Johnsen - University of Washington, Seattle, WashingtonSunil Patel - University of California-San Diego, San Diego, CaliforniaAdam Kinnaird - Division of Urology, University of Alberta, Edmonton, Alberta, CanadaBradley A Erickson - Departments of Urology, University of Iowa, Iowa City, IowaBryan Voelzke - University of Washington, Seattle, WashingtonJill Buckley - University of California-San Diego, San Diego, CaliforniaKeith Rourke
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.201(2), pp.364-370
- Publisher
- United States
- DOI
- 10.1016/j.juro.2018.09.051
- PMID
- 30266331
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Language
- English
- Date published
- 02/2019
- Academic Unit
- Urology
- Record Identifier
- 9984051589002771
Metrics
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