000			03736nam a22005177a 4500
008			201006s20202020 xxu||||| |||| 00| 0 eng d
022			_a0724-4983
024			_a10.1007/s00345-020-03446-y [doi]
024			_a10.1007/s00345-020-03446-y [pii]
040			_aOvid MEDLINE(R)
099			_a32944804
245			_aA multi-institutional critical assessment of dorsal onlay urethroplasty for post-radiation urethral stenosis.
251			_aWorld Journal of Urology. 39(7):2669-2675, 2021 Jul.
252			_aWorld J Urol. 39(7):2669-2675, 2021 Jul.
252			_zWorld J Urol. 2020 Sep 17
253			_aWorld journal of urology
260			_c2021
260			_fFY2022
265			_saheadofprint
265			_sppublish
266			_d2020-10-06
268			_aWorld Journal of Urology. 2020 Sep 17
520			_aCONCLUSION: Dorsal onlay buccal mucosa graft urethroplasty is a safe and feasible technique in patients with post-radiation posterior urethral stenosis. This non-transecting approach may confer low rates of de-novo SUI. Further research is needed to compare this technique with excisional urethroplasty.
520			_aMETHODS: Retrospective multi-institutional review of patients with posterior urethral stenosis from 10 institutions between 2010-2019 was performed. Patients with at least 1-year follow-up were assessed. Patient demographics, stenosis characteristics, peri-operative outcomes, and post-operative clinical and patient-reported outcomes were analyzed. The primary outcomes were stenosis recurrence and de-novo stress urinary incontinence (SUI). Secondary outcomes were changes in voiding, sexual function, and patient-reported satisfaction.
520			_aPURPOSE: To critically evaluate a multi-institutional patient cohort undergoing Dorsal-Onlay Buccal Mucosal Graft Urethroplasty (D-BMGU) for recurrent post-radiation posterior urethral stenosis.
520			_aRESULTS: Seventy-nine men with post-radiation urethral stenosis treated with D-BMGU met inclusion criteria. Median age and stenosis length were 72 years, (IQR 66-75), and 3.0 cm (IQR 2.5-4 cm), respectively. Radiation modalities included: 36 (45.6%) external beam radiotherapy (EBRT), 13 (16.5%) brachytherapy (BT), 10 (12.7%) combination EBRT/BT, and 20 (25.3%) EBRT/radical prostatectomy. At a median follow-up of 21 months (IQR 13-40), 14 patients (17.7%) had stenosis recurrence. Among 37 preoperatively-continent patients, 3 men (8.1%) developed de-novo SUI following dorsal onlay urethroplasty. Of 29 patients with preoperative SUI all but one remained incontinent post-operatively (96.6%). Following repair, patients experienced significant improvement in PVR (92.5 to 26 cc, p = 0.001) and Uroflow (4.6 to 15.9 cc/s, p = 0.001), and high overall satisfaction, with 91.9% reporting a GRA of + 2 or better).
546			_aEnglish
650			_a*Mouth Mucosa/tr [Transplantation]
650			_a*Radiation Injuries/su [Surgery]
650			_a*Urethra/su [Surgery]
650			_a*Urethral Stricture/et [Etiology]
650			_a*Urethral Stricture/su [Surgery]
650			_aAged
650			_aHumans
650			_aMale
650			_aRecurrence
650			_aRetrospective Studies
650			_aUrologic Surgical Procedures, Male/mt [Methods]
651			_aMedStar Washington Hospital Center
656			_aUrology
657			_aJournal Article
700			_aVenkatesan, Krishnan
790			_aAngulo JC, Blakely S, Flynn BJ, Gupta S, Hughes M, Lumen N, Martins FE, Nikolavsky D, Policastro CG, Ramirez Perez EA, Redger K, Rusilko P, Simhan J, Venkatesan K
856			_uhttps://dx.doi.org/10.1007/s00345-020-03446-y _zhttps://dx.doi.org/10.1007/s00345-020-03446-y
942			_cART _dArticle
999			_c5561 _d5561