PD22-08 MALE ANTERIOR URETHRAL STRICTURES ARE COMMONLY TREATED WITHOUT IMAGING OR BEING OFFERED URETHROPLASTY

Abstract

You have accessJournal of UrologyTrauma/Reconstruction: Urethral Reconstruction (including Stricture) III1 Apr 2015PD22-08 MALE ANTERIOR URETHRAL STRICTURES ARE COMMONLY TREATED WITHOUT IMAGING OR BEING OFFERED URETHROPLASTY Justin De Grado, Rachel Quinn, and Joel Gelman Justin De GradoJustin De Grado More articles by this author , Rachel QuinnRachel Quinn More articles by this author , and Joel GelmanJoel Gelman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1450AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES We evaluated the percentage of urethral stricture patients presenting to our institution who had prior internal urethrotomy (IU) or dilation without prior imaging and/or being offered open reconstruction during informed consent. METHODS After IRB approval, we prospectively collected data on all adult patients seen from April 2011 – January 2014 who were previously evaluated and/or treated for anterior stricture disease. We identified 103 men, and evaluated demographics, disease related information, medical records, outside imaging, and whether the patient was imaged and/or offered urethroplasty prior to treatment. RESULTS Ninety-one patients (88%) had been previously treated prior to being evaluated at our institution. Of the 91 men, 76 (84%) were treated without imaging. Of these 76 patients, 51 had IU as their initial treatment. Forty-three of the 51 had multiple procedures (range 2-5). The other 25 of the 91 treated patients were dilated. Fifteen had multiple (range 2-7) dilations. Only 13/58 (22%) who had multiple procedures had imaging after one or more failures prior to additional endoscopic treatment. Of the 91 patients who underwent prior treatment, 82 (90%) of them were treated with IU or dilation without being offered urethroplasty, and 57/82 had multiple dilations and/or IUs without being informed that urethral reconstruction was a treatment option. CONCLUSIONS While urethral imaging to define stricture characteristics including length, location and number is generally recommended prior to treatment in major textbooks and published literature, the vast majority of men diagnosed with urethral strictures via cystoscopy were treated (often repeatedly) endoscopically without prior imaging. Moreover, 90% of men with urethral strictures were treated with single and more often multiple endoscopic procedures without being offered urethroplasty as a treatment option. This is of interest given that recent literature suggests the success rate of IU is very low, the cure rate of repeated dilations and IUs approaches 0, and open urethroplasty offers cure rates of 90-98+ %. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e479 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Justin De Grado More articles by this author Rachel Quinn More articles by this author Joel Gelman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...