MP56-11 REFRACTORY LOWER URINARY TRACT SYMPTOMS (LUTS) FOLLOWING SUCCESSFUL URETHROPLASTY: FURTHER EXAMINING "LUTS FAILURE”

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) III (MP56)1 Sep 2021MP56-11 REFRACTORY LOWER URINARY TRACT SYMPTOMS (LUTS) FOLLOWING SUCCESSFUL URETHROPLASTY: FURTHER EXAMINING "LUTS FAILURE” David Chapman, Jordan Bekkema, and Keith Rourke David ChapmanDavid Chapman More articles by this author , Jordan BekkemaJordan Bekkema More articles by this author , and Keith RourkeKeith Rourke More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002086.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: An ill-defined proportion of patients undergoing urethroplasty fail to experience improvement in lower urinary tract symptoms (LUTS) despite being stricture-free. We aim to identify the incidence, associations, and causes of “LUTS failure” after urethroplasty. METHODS: Patients undergoing urethroplasty over a 6-year period were offered enrollment in a prospective study examining urinary function after urethroplasty. Patients were assessed pre-operatively and 6-months postoperatively using the international prostate symptom score (IPSS) and cystoscopy. “LUTS failure” was defined as less than 3-point improvement in IPSS, despite an anatomically successful urethroplasty. Multivariable logistic regression was utilized to evaluate the association of several patient factors with “LUTS Failure”. RESULTS: Of 365 patients meeting inclusion criteria, mean postoperative IPSS (20.3 vs. 5.4; p<0.0001) and median urinary quality of life (UQOL)(5 vs. 1; p<0.0001) were significantly improved. Despite being stricture-free, 7.7% of patients reported “LUTS failure” and 10.1% reported UQOL non-response. On multivariable logistic regression, increasing age (O.R.1.04, 95%CI 1.01-1.06, p=0.006) and hypospadias (O.R.18.2, 95%CI 2.1-156.0, p=0.008) were associated with “LUTS failure” while stricture location (p=0.76), length (p=0.14), previous urethroplasty (p=0.96), failed endoscopic treatment (p=0.17), type of urethroplasty (p=0.93) and other etiologies were not. Qualitatively, the most common causes of “LUTS failure” were detrusor underactivity (39.3%), detrusor overactivity (21.4%), pelvic floor dysfunction (21.4%) or BPH (14.3%). Only increasing age was associated with UQOL non-response (O.R.1.03, 95%CI 1.01-1.07, p=0.02). CONCLUSIONS: While many patients experience improved voiding function after urethroplasty, 7.7% experience “LUTS failure” and 10.1% report UQOL non-response. Both occurrences are independently associated with increasing patient age and most commonly related to detrusor underactivity. Source of Funding: Northern Alberta Urology Foundation © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e973-e973 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information David Chapman More articles by this author Jordan Bekkema More articles by this author Keith Rourke More articles by this author Expand All Advertisement Loading ...