Posterior Urethroplasty Complexity and Prognosis Can be Described by a Novel Method: Posterior Urethral Stenosis Score
| Autor: | Lin Wang, Hailin Guo, Chongrui Jin, Huiquan Shu, Xiangguo Lv, Qiang Fu, Yinglong Sa |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Urologic Surgical Procedures Male Adolescent Urethral stricture Urology Urethroplasty medicine.medical_treatment 030232 urology & nephrology Urinary incontinence Anastomosis Urethral stenosis Severity of Illness Index Young Adult 03 medical and health sciences 0302 clinical medicine Urethra medicine Humans Aged Retrospective Studies Urethral Stricture business.industry Middle Aged Prognosis medicine.disease Surgery Stenosis Erectile dysfunction medicine.anatomical_structure 030220 oncology & carcinogenesis medicine.symptom business |
| Zdroj: | Urology. 112:186-190 |
| ISSN: | 0090-4295 |
| DOI: | 10.1016/j.urology.2017.09.004 |
| Popis: | Objective To develop a standardized PU-score (posterior urethral stenosis score), with the goal of using this scoring system as a preliminary predictor of surgical complexity and prognosis of posterior urethral stenosis. Patients and Methods We retrospectively reviewed records of all patients who underwent posterior urethral surgery at our institution from 2013 to 2015. The PU-score is based on 5 components, namely etiology (1 or 2 points), location (1-3 points), length (1-3 points), urethral fistula (1 or 2 points), and posterior urethral false passage (1 point). We calculated the score of all patients and analyzed its association with surgical complexity, stenosis recurrence, intraoperative blood loss, erectile dysfunction, and urinary incontinence. Results There were 144 patients who underwent low complexity urethral surgery (direct vision internal urethrotomy, anastomosis with or without crural separation) with a mean score of 5.1 points, whereas 143 underwent high complexity urethroplasty (anastomosis with inferior pubectomy or urethrorectal fistula repair, perineal or scrotum skin flap urethroplasty, bladder flap urethroplasty) with a mean score of 6.9 points. The increase of PU-score was predictive of higher surgical complexity (P = .000), higher recurrence (P = .002), more intraoperative blood loss (P = .000), and decrease of preoperative (P = .037) or postoperative erectile function (P = .047). However, no association was observed between PU-score and urinary incontinence (P = .213). Conclusion The PU-score is a novel and meaningful scoring system that describes the essential factors in determining the complexity and prognosis for posterior urethral stenosis. |
| Databáze: | OpenAIRE |
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