Abstract
PURPOSE: Postoperative surveillance urethroscopy has been shown to be an effective tool to predict reoperation within 1 year after urethroplasty. We aimed to evaluate early surveillance urethroscopy findings and long-term outcomes among urethroplasty patients in order to define the value of surveillance urethroscopy to predict failure.
MATERIALS AND METHODS: We evaluated 304 patients with at least 4 years of followup after urethroplasty performed at 10 institutions across the United States and Canada. All patients were surveilled using a flexible 17Fr cystoscope and were categorized into 3 groups: 1) normal lumen, 2) large-caliber stricture (≥17Fr) defined as the ability of the cystoscope to easily pass the narrowing and 3) small-caliber stricture (<17Fr) that the cystoscope could not be passed. Failure was stricture recurrence requiring a secondary intervention.
RESULTS: The median followup time was 64.4 months (range 55.3-80.6) and the time to initial surveillance urethroscopy was 3.7 months (range 3.1-4.8) following urethroplasty. Secondary interventions were performed in 29 of 194 (15%) with normal lumens, 11 of 60 (18.3%) with ≥17Fr strictures and 32 of 50 (64%) with <17Fr strictures (p <0.001). The 1-, 3- and 9-year cumulative probability of intervention was 0.01, 0.06 and 0.23 for normal, 0.05, 0.17 and 0.18 for ≥17Fr, and 0.32, 0.50 and 0.73 for <17Fr lumen groups, respectively. Patient-reported outcome measures performed poorly to differentiate the 3 groups.
CONCLUSIONS: Early cystoscopic visualization of scar recurrence that narrows the lumen to <17Fr following urethroplasty is a significant long-term predictor for patients who will eventually undergo a secondary intervention.
Original language | English (US) |
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Pages (from-to) | 857-864 |
Number of pages | 8 |
Journal | Journal of Urology |
Volume | 207 |
Issue number | 4 |
DOIs | |
State | Published - Apr 1 2022 |
Bibliographical note
Funding Information:Supported by a grant from Boston Scientific fellowship.
Publisher Copyright:
© 2022 Lippincott Williams and Wilkins. All rights reserved.
Keywords
- cystoscopy
- reconstructive surgical procedures
- recurrence
- urethra
- urethral stricture
- Recurrence
- Reoperation
- Follow-Up Studies
- Humans
- Middle Aged
- Urethra/surgery
- Reconstructive Surgical Procedures/adverse effects
- Urologic Surgical Procedures, Male/adverse effects
- Aged, 80 and over
- Aged
- Endoscopy
- Postoperative Complications/diagnosis
- Urethral Stricture/diagnosis
PubMed: MeSH publication types
- Multicenter Study
- Journal Article