PD44-12 FIRST-STAGE URETHROPLASTY: FAILURES AND THEIR MANAGEMENT

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You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) III1 Apr 2016PD44-12 FIRST-STAGE URETHROPLASTY: FAILURES AND THEIR MANAGEMENT Lindsay A. Hampson, Keith Rourke, Alex J. Vanni, Sean Elliott, Jeremy B. Myers, Thomas G. Smith, and Bryan B. Voelzke Lindsay A. HampsonLindsay A. Hampson More articles by this author , Keith RourkeKeith Rourke More articles by this author , Alex J. VanniAlex J. Vanni More articles by this author , Sean ElliottSean Elliott More articles by this author , Jeremy B. MyersJeremy B. Myers More articles by this author , Thomas G. SmithThomas G. Smith More articles by this author , and Bryan B. VoelzkeBryan B. Voelzke More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1804AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Complex anterior urethral strictures may require two-stage reconstruction. To our knowledge, there are no published data on patients who fail 1st stage urethral reconstruction. We sought to elucidate 1st stage urethroplasty failures and their subsequent management. METHODS Data on all individuals who underwent 1st stage urethroplasty between 8/6/2003 - 10/6/2015 were retrospectively collected. Data on characteristics of patients, strictures, surgery, and failures were included. Complications were defined a priori (DVT, MI, PE, hematoma, infection, readmission). Patients were only included for surgeons with complete 1st stage outcome data (6 surgeons). Bivariate analysis was conducted with logistic regression and Fisher′s exact test. RESULTS 171 patients met inclusion criteria, with 18 (10.5%) failures after 1st stage repair. In bivariate analysis, only past/present tobacco use (p = 0.03) and presence of a complication (p < 0.01) predicted failure (Table 1). Failure etiology and management is shown in Table 2. The mean time between 1st and 2nd stage for successful 1st stage outcomes was 9.9 months, compared to 14.2 months for failures that were successfully salvaged and went on to 2nd stage. For salvaged failures, mean time from 1st stage to salvage surgery was 7.3 months, and from salvage surgery to 2nd stage was 9.0 months. Of failures who underwent salvage surgery, 9/12 (75%) were successful. CONCLUSIONS This represents the first comprehensive analysis of first-stage failures. Failures are often a result of poor graft take, contracture, or urethrostomy stenosis. Future work to determine predictors of these mechanisms will require greater number of failures to analyze. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1002 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Lindsay A. Hampson More articles by this author Keith Rourke More articles by this author Alex J. Vanni More articles by this author Sean Elliott More articles by this author Jeremy B. Myers More articles by this author Thomas G. Smith More articles by this author Bryan B. Voelzke More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...