MP60-14 VALIDATING THE CLINICAL UTILITY OF THE LSE URETHRAL STRICTURE CLASSIFICATION SYSTEM

Abstract

INTRODUCTION AND OBJECTIVE: A urethral stricture classification system based on stricture length (L), segment (S) and etiology (E) has been previously validated to have sufficient inter-rater reliability when classifying a urethral stricture based on the retrograde urethrogram, physical exam and urethral stricture history. The purpose of this study is to determine the ability for system to predict urethroplasty type and urethral stricture etiology. METHODS: The LSE classification system has been described before. A graphical depiction of the (S) sub-classifications are shown in Figure 1. We used the full LSE system to retrospectively classify the 2162 urethroplasty cases in the Trauma and Urologic Reconstruction Network of Surgeons (TURNS) database and then determined the distributions of repair types (categorized by excisional, substitutional, urethrostomy, and combinations thereof) and presumed etiologies within each (S) sub-classification. To determine if urethroplasty and etiology distributions were unique amongst S sub-classifications, Fischer’s Exact Test and the Cochran-Mantel-Haenszel tests were used, respectively. RESULTS: Distributions of repair type and etiologies are shown in Figure 2 below. Repair types differed significantly by (S) sub-classification (p = 0.0005) even after controlling for stricture length (L). Presumed etiologies differed significantly by (S) sub-classification (p = 0.0005). CONCLUSIONS: The clinical utility of the LSE urethral stricture classification system was validated here. Specifically, the (S) sub-classification was a strong predictor of urethroplasty type, indicating it would be a useful facilitator of clinical discussions amongst surgeons and with patients. The (S) sub-classification was also a strong predictor of stricture etiology, indicating that stricture pathophysiology varies significantly by urethral segment.Source of Funding: NIH Funding: 1R21DK115945-01