MP60-15 5-YEAR LONGITUDINAL OUTCOMES AFTER ANTERIOR URETHROPLASTY

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, and to predict for urethroplasty type and stricture etiology. The purpose of this study is to determine if urethroplasty outcomes varied significantly by LSE stricture classification. METHODS: A graphical depiction of the (S) sub-classifications are shown in Figure 1. Five-year longitudinal analysis was available for 530 cases from six surgeons in the Trauma and Urologic Reconstruction Network of Surgeons. These cases were retrospectively classified using the LSE system and primary (functional surgical success) and secondary (persistent of bothersome lower urinary tract symptoms (LUTS), de novo sexual dysfunction, de novo genital pain) outcomes were determined. Differences in primary and secondary outcomes between (S) sub-classifications were determined with Kaplan-Meier and Chi-squared analyses, respectively. RESULTS: Overall functional success rate was 86%, which varied significantly by (S) sub-classification (Figure 2). Persistent post-operative urinary complaints were present in 21.3%, de novo sexual dysfunction in 9.6% and clinically significant perineal pain in 0.5%. Only persistent urinary complaints varied by (S) subclassification with 41% of S2c strictures reporting persistent complaints. CONCLUSIONS: We confirmed the validity of the LSE classification system to predict surgical outcomes. Utilization of the classification system will improve our abilities to compare surgical techniques for similarly classified strictures.Source of Funding: NIH Funding 1R21DK115945-01