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

Autor: Horiguchi, Akio, Shinchi, Masayuki, Ojima, Kenichiro, Arai, Yuichi, Hatanaka, Mina, Ito, Keiichi, Asano, Tomohiko, Takahashi, Eiji, Kimura, Fumihiro, Azuma, Ryuichi
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Zdroj: World Journal of Urology; Jul2020, Vol. 38 Issue 7, p1805-1811, 7p
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. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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