You have accessJournal of UrologyTrauma/Reconstruction: Traum & Reconstructive Surgery (1)1 Apr 20136 MULTI-INSTITUTIONAL ONE-YEAR BULBAR URETHROPLASTY OUTCOMES USING A STANDARDIZED PROSPECTIVE CYSTOSCOPIC FOLLOW-UP PROTOCOL Bradley Erickson, Sean Elliott, Bryan Voelzke, Jeremy Myers, Joshua Broghammer, Thomas Smith, Chris McClung, Nejd Alsikafi, and William Brant Bradley EricksonBradley Erickson Iowa City, IA More articles by this author , Sean ElliottSean Elliott Minneapolis, MN More articles by this author , Bryan VoelzkeBryan Voelzke Seattle, WA More articles by this author , Jeremy MyersJeremy Myers Salt Lake City, UT More articles by this author , Joshua BroghammerJoshua Broghammer Kansas City, KS More articles by this author , Thomas SmithThomas Smith Houston, TX More articles by this author , Chris McClungChris McClung Columbus, OH More articles by this author , Nejd AlsikafiNejd Alsikafi Maywood, IL More articles by this author , and William BrantWilliam Brant Salt Lake City, UT More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1380AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES A standardized follow-up protocol and definition of failure after urethral reconstructive surgery is needed to allow meaningful comparison of outcomes between series and operative techniques. The purpose of the study was to evaluate multi-institutional outcomes of bulbar urethroplasty utilizing a standard follow-up protocol. METHODS Between 6/2010 and 8/2011, eight reconstructive surgeons prospectively enrolled urethral stricture patients in a multi-institutional, IRB approved study. The approved protocol included performing a cystoscopy at 3 and 12 months after reconstruction. Failure was defined as the inability to pass a flexible cystoscope past the area of reconstruction without force. Patients with voiding complaints at time of cystoscopy were considered “symptomatic.” For this study, men not compliant with the protocol were called and asked 1) “Is your urination better than before surgery” and 2) “Has your urethra been instrumented since surgery - with answers of yes/no respectively representing a success. We reported 3 success rates for the cohort 1) Cystoscopy with no recurrence 2) Cystoscopy or phone call with no recurrence 3) Cystoscopy/phone call or lost to follow-up at one-year (with presumed success). RESULTS Included were 190 single-stage bulbar urethroplasties performed by 7 surgeons (mean 27). Compliance with protocol follow-up cystoscopy was 79% at 3 mo and 55% at 12 mo which did not differ significantly by surgeon. Success rates are shown in the figure. Of the 16 recurrences found by cystoscopy, 12 (75%) were symptomatic at the time of the procedure. CONCLUSIONS 1-year success rates after bulbar urethroplasty of those compliant with our standardized follow-up protocol were 89% and 76% for excisional and buccal urethroplasty respectively. When less stringent definitions of failure are used, which are the most commonly used in the current literature, success rates increased significantly. Of recurrences found by cystoscopy, 25% were asymptomatic at time of failure, implying that a significant percentage of men may have asymptomatic recurrences. Institution of this cystoscopic protocol was difficult despite the prospective nature of the study, as compliance was a challenge with all 7 surgeon cohorts. 1-year outcomes after bulbar urethroplasty utilizing a standardized follow-up protocol Case Type Total Cases Success Rate 1⁎ Success Rate 2⁎⁎ Success Rate 3⁎⁎⁎ p value Excision/Anastomotic 121 65/73(89%) 86/95(91%) 112/121(93%) 0.69 Buccal Grafting 70 25/33(76%) 39/47(83%) 62/70(89%) 0.25 ⁎ Includes only men completing 1 year follow-up protocol; ⁎⁎ Includes men completing protocol and/or reached by phone; ⁎⁎⁎ Includes all men enrolled in study © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e2-e3 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bradley Erickson Iowa City, IA More articles by this author Sean Elliott Minneapolis, MN More articles by this author Bryan Voelzke Seattle, WA More articles by this author Jeremy Myers Salt Lake City, UT More articles by this author Joshua Broghammer Kansas City, KS More articles by this author Thomas Smith Houston, TX More articles by this author Chris McClung Columbus, OH More articles by this author Nejd Alsikafi Maywood, IL More articles by this author William Brant Salt Lake City, UT More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...