Surgical and patient-reported outcomes of urethroplasty for bulbar stricture due to a straddle injury.

Autor: Horiguchi A; Department of Urology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan. asukamaru513@gmail.com., Shinchi M; Department of Urology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan., Ojima K; Department of Urology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan., Arai Y; Department of Urology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan., Hatanaka M; Department of Urology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan., Ito K; Department of Urology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan., Asano T; Department of Urology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan., Takahashi E; Department of Urology, Nishisaitama-chuo National Hospital, Saitama, Japan., Kimura F; Department of Urology, Nishisaitama-chuo National Hospital, Saitama, Japan., Azuma R; Department of Plastic Surgery, National Defense Medical College, Saitama, Japan.
Jazyk: angličtina
Zdroj: World journal of urology [World J Urol] 2020 Jul; Vol. 38 (7), pp. 1805-1811. Date of Electronic Publication: 2019 Sep 26.
DOI: 10.1007/s00345-019-02971-9
Abstrakt: Purpose: To report our experience with urethroplasty for bulbar stricture due to a straddle injury based on surgical and patient-reported outcomes.
Methods: Patients who underwent urethroplasty for bulbar stricture due to a straddle injury between 2010 and 2018 were retrospectively analyzed (N = 132). Successful urethroplasty was defined as the absence of the need for additional treatment. The patients completed the validated Urethral Stricture Surgery Patient-reported Outcome Measure and Sexual Health Inventory for Men (SHIM) questionnaires before (baseline) and 1 year after urethroplasty.
Results: The median (interquartile range) age was 50 (36-62) years; urethral stricture length estimated from urethrograms, 8.6 (5.1-12.5) mm; and postoperative follow-up, 41 (22-56) months. Urethroplasty was performed through excision with primary anastomosis in 95.5% (n = 126) and onlay augmentation with a buccal mucosa graft in 4.5% (n = 6). Urethroplasty was successful in 98.5% (n = 130). The 2 failures due to periurethral abscess were successfully salvaged with another urethroplasty. Eighty-four patients (63.6%) completed the questionnaires at 1 year postoperatively. The mean lower urinary tract (LUT)-specific quality of life, SHIM, and EuroQol-visual analog scale scores all improved significantly from 2.6, 8.5, and 57.5 at baseline to 0.3, 11.6, and 84.6 postoperatively (p < 0.0001, p = 0.004, p < 0.0001, respectively). All patients were either "satisfied" (19/84, 22.6%) or "very satisfied" (65/84, 77.3%). Lower postoperative LUT symptom score was an independent predictor of a "very satisfied" patient (odds ratio 0.81, 95% confidence interval 0.67-0.98, p = 0.002).
Conclusions: Urethroplasty for bulbar stricture due to a straddle injury has a high success rate and is beneficial for both subjective and objective symptoms.
Databáze: MEDLINE
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