Clinical and Patient-Reported Outcomes of One-Sided Anterior Urethroplasty for Long-Segment or Panurethral Strictures.
Citation: Urology. 111:208-213, 2018 Jan.PMID: 28864340Institution: MedStar Washington Hospital CenterDepartment: UrologyForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Patient Reported Outcome Measures | *Urethra/su [Surgery] | *Urethral Stricture/su [Surgery] | Adult | Aged | Aged, 80 and over | Humans | Male | Middle Aged | Mouth Mucosa/tr [Transplantation] | Retrospective Studies | Sexual Behavior/ph [Physiology] | Treatment Outcome | Urethral Stricture/pa [Pathology] | Urination | Urologic Surgical Procedures, Male/mt [Methods] | Young AdultYear: 2018Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007ISSN:- 0090-4295
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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Journal Article | MedStar Authors Catalog | Article | 28864340 | Available | 28864340 |
Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007
CONCLUSIONS: Durable patency in most patients is demonstrated in this study. Patient-reported outcome measures indicate an improvement in urinary function and moderate effect on sexual function. Transient penile chordee was evident in 25% of patients. Copyright (c) 2017. Published by Elsevier Inc.
METHODS: Patients from four institutions after single-stage repairs for long-segment urethral strictures (> 8 cm) from January 2002 to April 2016 were reviewed. Technique described by Kulkarni et al was used in all cases. Clinical outcomes included uroflowmetry (Qmax), post-void residuals (PVR). PROMs included IPSS survey, SHIM, Male Sexual Health Questionnaire (MSHQ-EjS) and Global Response Assessment questionnaire (GRA) to measure voiding, sexual, ejaculatory symptoms and overall improvement respectively.
OBJECTIVES: To evaluate clinical and patient-reported urinary and sexual outcomes after a long-segment stricture repair using the one-sided urethral dissection, penile invagination and dorsal BMG onlay technique described by Kulkarni.
RESULTS: Seventy-three patients with a minimum of 12-months follow-up were included. The mean age and stricture length were 56(21-80) years and 13.6(8-21) cm respectively. At a mean follow-up of 44(12-162) months, 9/73(12%) strictures recurred. The mean baseline IPSS score of 23(7-24) decreased to 10(1-17) on follow-up (p <0.001). 8/42 patients (21.4%) reported an increase and 6/42 patients (14.3%) decrease in SHIM following urethroplasty. Ejaculatory function on MSHQ-EjS improved after urethroplasty from 8 pre-operatively to 11 post-operatively (p<0.004). All patients reported improvement after urethroplasty on GRA questionnaire. Post-void dribbling and chordee occurred in 45% and 25% of patients respectively.
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