MP78-01 EFFECT OF URETHRAL STRICTURE AUA GUIDELINES ON NATIONAL TRENDS IN RECONSTRUCTIVE MANAGEMENT

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP78-01 EFFECT OF URETHRAL STRICTURE AUA GUIDELINES ON NATIONAL TRENDS IN RECONSTRUCTIVE MANAGEMENT Samuel Sorkhi, Sirpi Nackeeran, Michael Witthaus, Jill Buckley, and M. Raj Rajasekaran Samuel SorkhiSamuel Sorkhi More articles by this author , Sirpi NackeeranSirpi Nackeeran More articles by this author , Michael WitthausMichael Witthaus More articles by this author , Jill BuckleyJill Buckley More articles by this author , and M. Raj RajasekaranM. Raj Rajasekaran More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003355.01AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Urethral Stricture Disease (USD) is a pathological narrowing of the urethra that often results in lower urinary tract symptoms (LUTS), urinary incontinence, urinary tract infections, and ultimately progression toward acute urinary retention. In 2016, the AUA released guidelines on urethral stricture management, focusing on the importance of an earlier transition to urethroplasty rather than repeat endoscopic procedures. This study aims to analyze the recent trends in male urethral stricture treatment from 2016-2020 to determine the impact of the AUA’s most recent guidelines on male urethral stricture management. METHODS: We utilized electronic health record data stored within the TriNetX Research Network to conduct a retrospective analysis of procedures performed between 2016-2020 (a total of 78,532 procedures). Rates of direct visual internal urethrotomy (DVIU), urethral dilation, dilation+DVIU, and urethroplasty were analyzed using chi-square analysis to assess linear trends. RESULTS: The dilation+DVIU group showed a significant increase in procedure rates between 2016-2017 (p=1.269E-08), 2016-2018 (p=5.08E-07), 2016-2019 (p=2.7637E-31), and 2018-2019 (p=5.38E-13; Figure 1A-B). While 2019-2020 showed a decrease (p=4.792E-06), an analysis of the overall trend from 2016-2020 demonstrated no significant difference (p=0.07739). Urethroplasty was offered to younger patients when compared to urethral dilation/incision (Figure 1C) performed in older patients. Repeat dilation/incisions were performed at significantly (22%) higher rates when compared to urethroplasty (Figure 1D). CONCLUSIONS: Despite AUA recommendations encouraging reconstructive surgeons to offer urethroplasty instead of repeated endoscopic interventions, our results suggest no significant change in the rates of these procedures after the release of the 2016 AUA urethral stricture guidelines. The lack of clinical modification may reflect the lag-time incorporating guideline recommendations or practice barriers to implementation. Source of Funding: UCSD Academic Senate © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1131 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Samuel Sorkhi More articles by this author Sirpi Nackeeran More articles by this author Michael Witthaus More articles by this author Jill Buckley More articles by this author M. Raj Rajasekaran More articles by this author Expand All Advertisement PDF downloadLoading ...