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01-12-2019 | Urethral Stricture | Original Article

Clinical significance of cystoscopic urethral stricture recurrence after anterior urethroplasty: a multi-institution analysis from Trauma and Urologic Reconstructive Network of Surgeons (TURNS)

Authors: Nima Baradaran, Kirkpatrick B. Fergus, Rachel A. Moses, Darshan P. Patel, Thomas W. Gaither, Bryan B. Voelzke, Thomas G. Smith III, Bradley A. Erickson, Sean P. Elliott, Nejd F. Alsikafi, Alex J. Vanni, Jill Buckley, Lee C. Zhao, Jeremy B. Myers, Benjamin N. Breyer

Published in: World Journal of Urology | Issue 12/2019

Abstract

Purpose

To assess the functional Queryoutcome of patients with cystoscopic recurrence of stricture post-urethroplasty and to evaluate the role of cystoscopy as initial screening tool to predict future failure.

Methods

Cases with cystoscopy data after anterior urethroplasty in a multi-institutional database were retrospectively studied. Based on cystoscopic evaluation, performed within 3-months post-urethroplasty, patients were categorized as small-caliber (SC) stricture recurrence: stricture unable to be passed by standard cystoscope, large-caliber (LC) stricture accommodating a cystoscope, and no recurrence. We assessed the cumulative probability of intervention and the quality of life scores in association with cystoscopic recurrence 1-year post-urethroplasty. Patients with history of hypospadias, perineal urethrostomy, urethral fistula, and meatal pathology were excluded.

Results

From a total of 2630 men in our cohort, 1054 patients met the inclusion criteria: normal (n = 740), LC recurrence (n = 178), and SC recurrence (n = 136) based on the first cystoscopic evaluation performed at median 111 days postoperatively. Median follow-up was 350 days (IQR 121–617) after urethroplasty. Cystoscopic recurrence was significantly associated with secondary interventions (2.7%, 6.2%, 33.8% in normal, LC, and SC groups, respectively). Quality of life variables were not statistically significantly different among the three study groups.

Conclusions

Many patients with cystoscopic recurrence do not need an intervention after initial urethroplasty. Despite good negative predictive value, cystoscopy alone may be a poor screening test for stricture recurrence defined by patient symptoms and need for secondary interventions.

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Title: Clinical significance of cystoscopic urethral stricture recurrence after anterior urethroplasty: a multi-institution analysis from Trauma and Urologic Reconstructive Network of Surgeons (TURNS)
Authors: Nima Baradaran
Kirkpatrick B. Fergus
Rachel A. Moses
Darshan P. Patel
Thomas W. Gaither
Bryan B. Voelzke
Thomas G. Smith III
Bradley A. Erickson
Sean P. Elliott
Nejd F. Alsikafi
Alex J. Vanni
Jill Buckley
Lee C. Zhao
Jeremy B. Myers
Benjamin N. Breyer
Publication date: 01-12-2019
Publisher: Springer Berlin Heidelberg
Keyword: Urethral Stricture
Published in: World Journal of Urology / Issue 12/2019
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-019-02653-6

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Clinical significance of cystoscopic urethral stricture recurrence after anterior urethroplasty: a multi-institution analysis from Trauma and Urologic Reconstructive Network of Surgeons (TURNS)

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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