摘要
Background: Urethroplasty is the gold standard for treatment for urethral strictures. We describe our results of urethroplasty and analyse the risk factors associated with stricture recurrence and stricture-free survival. Methods: A retrospective review of urethroplasty surgery carried out from 2016-2022. Patient records were analysed to obtain demographics, clinical, pathological and outcome data. Success of surgery is defined as postoperative Qmax > 15 ml/s or absence of any instrumentation of urethra such as urethral dilatation, after removal of urethral indwelling catheter. Results: A total of 66 patients who fulfilled the inclusion criteria were selected. Mean age was 43.8. Mean follow up was 27.2 ± 21.8 months. Stricture recurred in 18 patients (27.3%). Estimated stricture free survival time was 59.6 months (95% CI: 50.87 - 68.37). Previous surgical history for stricture was found to be predictive of stricture recurrence. After adjusting for age, BMI, aetiology of stricture and stricture length, previous surgical history had a risk of stricture recurrence approximately three times higher compared to those without. Conclusion: Previous surgical intervention for urethral stricture was found to be the most significant factor for stricture recurrence. We strongly advocate that the first curative surgery done for urethral strictures should be done in high volume centres and by experienced reconstructive urologists.
Background: Urethroplasty is the gold standard for treatment for urethral strictures. We describe our results of urethroplasty and analyse the risk factors associated with stricture recurrence and stricture-free survival. Methods: A retrospective review of urethroplasty surgery carried out from 2016-2022. Patient records were analysed to obtain demographics, clinical, pathological and outcome data. Success of surgery is defined as postoperative Qmax > 15 ml/s or absence of any instrumentation of urethra such as urethral dilatation, after removal of urethral indwelling catheter. Results: A total of 66 patients who fulfilled the inclusion criteria were selected. Mean age was 43.8. Mean follow up was 27.2 ± 21.8 months. Stricture recurred in 18 patients (27.3%). Estimated stricture free survival time was 59.6 months (95% CI: 50.87 - 68.37). Previous surgical history for stricture was found to be predictive of stricture recurrence. After adjusting for age, BMI, aetiology of stricture and stricture length, previous surgical history had a risk of stricture recurrence approximately three times higher compared to those without. Conclusion: Previous surgical intervention for urethral stricture was found to be the most significant factor for stricture recurrence. We strongly advocate that the first curative surgery done for urethral strictures should be done in high volume centres and by experienced reconstructive urologists.
作者
Jeffrey Jiajian Lee
Ley Khim Teo
Jieling Cheng
Hamid Ghazali
Jeffrey Jiajian Lee;Ley Khim Teo;Jieling Cheng;Hamid Ghazali(Urology Department, Hospital Tengku Ampuan Afzan, Kementerian Kesihatan Malaysia, Putrajaya, Malaysia;Clinical Research Centre, Hospital Pulau Pinang, Kementerian Kesihatan Malaysia, Putrajaya, Malaysia;Institute for Clinical Research, National Institutes of Health, Ministry of Health Malaysia, Kuala Lumpur, Malaysia)
