Journal article
Urethroscopic Findings following Urethroplasty Predict the Need for Secondary Intervention in the Long Term: A Multi-Institutional Study from Trauma and Urologic Reconstructive Network of Surgeons
The Journal of urology, Vol.207(4), pp.857-865
04/2022
DOI: 10.1097/JU.0000000000002353
PMID: 34854754
Abstract
Postoperative surveillance urethroscopy has been shown to be an effective tool to predict reoperation within 1 year after urethroplasty. We aimed to evaluate early surveillance urethroscopy findings and long-term outcomes among urethroplasty patients in order to define the value of surveillance urethroscopy to predict failure.
We evaluated 304 patients with at least 4 years of followup after urethroplasty performed at 10 institutions across the United States and Canada. All patients were surveilled using a flexible 17Fr cystoscope and were categorized into 3 groups: 1) normal lumen, 2) large-caliber stricture (≥17Fr) defined as the ability of the cystoscope to easily pass the narrowing and 3) small-caliber stricture (<17Fr) that the cystoscope could not be passed. Failure was stricture recurrence requiring a secondary intervention.
The median followup time was 64.4 months (range 55.3-80.6) and the time to initial surveillance urethroscopy was 3.7 months (range 3.1-4.8) following urethroplasty. Secondary interventions were performed in 29 of 194 (15%) with normal lumens, 11 of 60 (18.3%) with ≥17Fr strictures and 32 of 50 (64%) with <17Fr strictures (p <0.001). The 1-, 3- and 9-year cumulative probability of intervention was 0.01, 0.06 and 0.23 for normal, 0.05, 0.17 and 0.18 for ≥17Fr, and 0.32, 0.50 and 0.73 for <17Fr lumen groups, respectively. Patient-reported outcome measures performed poorly to differentiate the 3 groups.
Early cystoscopic visualization of scar recurrence that narrows the lumen to <17Fr following urethroplasty is a significant long-term predictor for patients who will eventually undergo a secondary intervention.
Details
- Title: Subtitle
- Urethroscopic Findings following Urethroplasty Predict the Need for Secondary Intervention in the Long Term: A Multi-Institutional Study from Trauma and Urologic Reconstructive Network of Surgeons
- Creators
- Gregory M Amend - University of California, San FranciscoBehnam Nabavizadeh - University of California, San FranciscoNizar Hakam - University of California, San FranciscoBryan B Voelzke - Spokane Urology, Spokane, Washington.Thomas G Smith III - Department of Urology, MD Anderson Cancer Center, Houston, TexasBradley A Erickson - University of IowaSean P Elliott - University of MinnesotaNejd F Alsikafi - Uropartners, Gurnee, Illinois.Alex J Vanni - Lahey Hospital and Medical CenterJill C Buckley - University of California San DiegoLee C Zhao - New York UniversityJeremy B Myers - University of UtahAndrew C Peterson - Duke UniversityKeith F Rourke - University of AlbertaJoshua A Broghammer - University of KansasBenjamin N Breyer - University of California, San Francisco
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.207(4), pp.857-865
- DOI
- 10.1097/JU.0000000000002353
- PMID
- 34854754
- NLM abbreviation
- J Urol
- ISSN
- 1527-3792
- eISSN
- 1527-3792
- Language
- English
- Date published
- 04/2022
- Academic Unit
- Urology
- Record Identifier
- 9984320063102771
Metrics
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