PD16-02 VARIABLE DEFINITIONS OF URETHRAL STRICTURE RECURRENCE AFTER VISUAL INTERNAL URETHROTOMY AND URETHROPLASTY

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) I1 Apr 2016PD16-02 VARIABLE DEFINITIONS OF URETHRAL STRICTURE RECURRENCE AFTER VISUAL INTERNAL URETHROTOMY AND URETHROPLASTY Benjamin A Sherer, M. Ryan Farrell, Fahad Chaus, and Laurence A Levine Benjamin A ShererBenjamin A Sherer More articles by this author , M. Ryan FarrellM. Ryan Farrell More articles by this author , Fahad ChausFahad Chaus More articles by this author , and Laurence A LevineLaurence A Levine More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1154AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Experts and international panels have called for uniformity in defining “recurrence” after urethroplasty for urethral strictures based on data prior to 2010. We evaluated how urethral stricture recurrence after both urethroplasty and visual internal urethrotomy (VIU) is being evaluated and defined in subsequent contemporary series. METHODS We performed a systematic review of all studies reporting outcomes of either VIU or urethroplasty from 2009-2014. A PubMed/Medline search was performed using the terms urethroplasty, internal urethrotomy, and recurrence. Studies reporting number of patients treated, follow-up period, follow-up methods, and definition of stricture recurrence were included for review. RESULTS Among 39 contemporary studies meeting inclusion criteria (Urethroplasty n=26, VIU n=13) definitions of recurrence fell into 5 major categories: Need for repeat procedure/instrumentation (Urethroplasty 50.0%, n=13; VIU 15.4%, n=2; Overall 38.5%, n=15), inability to pass a cystoscope (16-18Fr or not specified) (Urethroplasty 26.9%, n=7; VIU 7.7%, n=1; Overall 20.5%, n=8), decreased Q max on uroflowmetry (Urethroplasty 7.7%, n=2; VIU 38.5%, n=5; Overall 17.9%, n=7), stricture visible on ultrasound (Urethroplasty 3.8%, n=1; VIU 0%, n=0; Overall 2.6%, n=1), or a combination of aforementioned modalities (Urethroplasty 11.5%, n=3; VIU 38.5%, n=5; Overall 20.5%, n=8). Of the combined modalities, 4 involved the presence of subjective symptoms. Overall, among the 39 studies, there were 18 unique definitions of stricture recurrence reported. Timing, frequency, and duration of follow-up also varied widely. CONCLUSIONS There remains wide variability in the reporting of outcomes after treatment of urethral strictures with urethroplasty or VIU. This makes any direct or longitudinal comparison between studies difficult. There is an ongoing need to establish uniform parameters for evaluating outcomes and defining urethral stricture recurrence after surgical intervention. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e394 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Benjamin A Sherer More articles by this author M. Ryan Farrell More articles by this author Fahad Chaus More articles by this author Laurence A Levine More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...