Treatments of 1242 bulbar urethral strictures: multivariable statistical analysis of results

被引:33
作者
Barbagli, Guido [1 ]
Montorsi, Francesco [2 ]
Balo, Sofia [1 ]
Sansalone, Salvatore [3 ]
Loreto, Carla [4 ]
Butnaru, Denis [5 ]
Bini, Vittorio [6 ]
Lazzeri, Massimo [7 ]
机构
[1] Ctr Chirurg Toscano, Arezzo, Italy
[2] IRCCS Osped San Raffaele, Div Oncol, Unit Urol, Urol Res Inst, Milan, Italy
[3] Univ Tor Vergata, Dept Expt Med & Surg, Rome, Italy
[4] Univ Catania, Dept Biomed & Biotechnol Sci, Sect Anat & Histol, Catania, Italy
[5] Sechenov First Moscow State Med Univ, Inst Regenerat Med, Moscow, Russia
[6] Univ Perugia, Dept Internal Med & Biostat, Perugia, Italy
[7] Humanitas Univ, Humanitas Clin & Researcher Ctr, Dept Urol, Rozzano, Italy
关键词
Urethra; Urethroplasty; Urethrotomy; Surgical technique; Oral mucosa; Skin graft; Long-term results; FREE-GRAFT URETHROPLASTY; BUCCAL MUCOSAL GRAFT; DORSAL; ANASTOMOSIS;
D O I
10.1007/s00345-018-2481-6
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
PurposeWe investigated the success rate of different surgical techniques for bulbar stricture repair.MethodsRetrospective study of patients with bulbar urethral strictures treated using different techniques. The primary outcome of the study was to evaluate the overall results of treatment (success vs. failure); the secondary outcome was to evaluate the outcome according to any surgical technique. Cysto-urethrography was performed 1month following surgery. Patients underwent clinical evaluation, uroflowmetry and residual urine measurement every 6months for 2years after surgery and later once on year. When patient showed obstructive symptoms, Q(max)<12ml/s, the urethrography was repeated. Patients who underwent further treatment for recurrent stricture were classified as failures. A bivariable and multivariable statistical analysis was performed.ResultsOverall, 1242 patients were included in the study with mean age 40years (range 12-84). Median stricture length was 4cm (range 1-8). The median follow-up was 103months (range 12-362). Over 1242 patients, 916 (73.8%) were success and 326 (26.2%) failures. Fourteen different surgical techniques showed a success rate ranging from 87.5 to 14.3%. The multivariable analysis showed that stricture length was an independent predictor factors for failure: p<0.0001 CI 1146-1509. End-end anastomosis and oral mucosa graft urethroplasty are independent predictor factor of success after internal urethrotomy failure.ConclusionsOur results showed that treatment of bulbar urethral stricture is satisfactory on 73.8% of patients, but with a wide range of success rate (from 14.3 to 87.5%) using different techniques. Oral mucosa is greatly superior to the skin as substitute material.
引用
收藏
页码:1165 / 1171
页数:7
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