000			03828nam a22005897a 4500
008			200902s20202020 xxu||||| |||| 00| 0 eng d
022			_a1677-5538
024			_a10.1590/S1677-5538.IBJU.2019.0511 [doi]
024			_aIBJU20190511 [pii]
040			_aOvid MEDLINE(R)
099			_a32758305
245			_aLarger patients shouldn't have fewer options: urethroplasty is safe in the obese.
251			_aInternational Braz J Urol. 46(6):962-970, 2020 Nov-Dec.
252			_aInt Braz J Urol. 46(6):962-970, 2020 Nov-Dec.
252			_zInt Braz J Urol. 46(6):962-970, 2020 Nov-Dec.
253			_aInternational braz j urol : official journal of the Brazilian Society of Urology
260			_c2020
260			_fFY2021
265			_sppublish
265			_sppublish
266			_d2020-09-02
268			_aInternational Braz J Urol. 46(6):962-970, 2020 Nov-Dec.
520			_aCONCLUSION: Despite the association with increased urethral stricture length and EBL, obesity is not predictive of adverse perioperative outcomes or stricture recurrence. Obese patients should be offered urethral reconstruction, but patient selection and preoperative counseling remain imperative. Copyright R by the International Brazilian Journal of Urology.
520			_aMATERIAL AND METHODS: We reviewed our prospectively maintained single-surgeon database to identify men with anterior urethral strictures who had undergone anastomotic or augmentation urethroplasty between October 2012 and March 2018. In all, 210 patients were included for primary analysis of perioperative outcomes, while 193 patients with at least 12 months follow-up were included for secondary analysis of stricture recurrence. Patients grouped by BMI were compared using univariate and multivariate analyses for perioperative outcomes and log rank testing for recurrence-free survival.
520			_aOBJECTIVE: To examine the impact of obesity on perioperative outcomes and urethral stricture recurrence after anterior urethroplasty.
520			_aRESULTS: Overall, 41% (n=86) of patients were obese and 58.6% (n=123) had bulbar urethral strictures. Obese patients had significantly longer urethral strictures (mean=6.7cm+/-4.7) than nonobese patients (p< 0.001). Though urethroplasty in obese patients was associated with increased estimated blood loss (EBL) relative to normal BMI patients on both univariate (p=0.003) and multivariate (p< 0.001) analyses, there was no difference in operative time, length of stay, or complication rate between BMI groups. At a mean follow-up interval of 36.7 months, 15% (n=29) of patients had stricture recurrence, yet recurrence-free survival was not significantly different between groups (log rank p=0.299). Dorsal augmentation urethroplasty resulted in significantly fewer recurrences in obese patients compared to nonobese patients (p=0.036).
546			_aEnglish
650			_a*Urethral Stricture
650			_a*Urologic Surgical Procedures, Male
650			_aAdult
650			_aAged
650			_aHumans
650			_aMale
650			_aMiddle Aged
650			_aNeoplasm Recurrence, Local
650			_aObesity/co [Complications]
650			_aRecurrence
650			_aRetrospective Studies
650			_aTreatment Outcome
650			_aUrethra/su [Surgery]
650			_aUrethral Stricture/su [Surgery]
651			_aMedStar Heart & Vascular Institute
651			_aMedStar Washington Hospital Center
656			_aUrology
657			_aJournal Article
700			_aDesale, Sameer
700			_aVenkatesan, Krishnan
700			_aWright, Henry Collier
790			_aAlger J, Desale S, Venkatesan K, Wright HC IV
856			_uhttps://dx.doi.org/10.1590/S1677-5538.IBJU.2019.0511 _zhttps://dx.doi.org/10.1590/S1677-5538.IBJU.2019.0511
942			_cART _dArticle
999			_c5463 _d5463