Incidence and Predictors of Complications due to Urethral Stricture in Patients Awaiting Urethroplasty.

Autor:	Hoy NY; Division of Urology, University of Alberta, Edmonton, Alberta, Canada., Chapman DW; Division of Urology, University of Alberta, Edmonton, Alberta, Canada., Dean N; Division of Urology, University of Alberta, Edmonton, Alberta, Canada., Rourke KF; Division of Urology, University of Alberta, Edmonton, Alberta, Canada. Electronic address: krourke@ualberta.ca.
Jazyk:	angličtina
Zdroj:	The Journal of urology [J Urol] 2018 Mar; Vol. 199 (3), pp. 754-759. Date of Electronic Publication: 2017 Sep 09.
DOI:	10.1016/j.juro.2017.08.113
Abstrakt:	Purpose: We examined the incidence and predictors of complications due to urethral stricture in patients awaiting urethroplasty. Materials and Methods: We retrospectively reviewed the charts of patients who underwent urethroplasty from 2009 to 2013. The primary outcome was complications, defined as any unplanned interaction with the health care system due to urethral stricture during the period between the decision to perform surgery and urethroplasty. Results: A total of 276 patients were identified for analysis. Median stricture length was 4.0 cm and 67.4% of strictures were in the bulbar urethra. The most common stricture etiologies were idiopathic in 47.8% of cases and traumatic in 15.9%. Overall 15.9% of patients presented with a complication with a median time to complication of 43 days. Median surgical wait time was 151 days. Complications included urinary tract infections in 56.8% of patients, acute urinary retention in 20.5%, genitourinary pain in 5.8% and catheter related issues in 15.9%. Univariate analysis suggested that catheter dependent status, number of prior endoscopic treatments, a hypospadias and/or trauma etiology, and prior urethroplasty were potential significant predictors of complications. Multivariate analysis yielded only catheter dependent status (HR 5.2, 95% CI 2.4-11.3, p <0.0001) and prior failed urethroplasty (HR 1.6, 95% CI 1.1-2.3, p = 0.03) as significantly associated with complications. Conclusions: To our knowledge our study is the first to examine and quantify the morbidity of urethroplasty wait time. Approximately 16% of patients experienced a complication while awaiting urethroplasty. The optimal wait time should be less than 43 days. Patients with prior urethroplasty and catheters at the time of the surgical decision should be prioritized as they may be more likely to experience complications. (Copyright © 2018 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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