Predictors of urethral stricture recurrence after endoscopic urethrotomy

Redon-Galvez, L.; Molina-Escudero, R.; Alvarez-Ardura, M.; Otaola-Arca, H.; Alarcon Parra, R. O.; Paez-Borda, A.

Abstract

Objective: The aim of the study was to analyse the clinical-demographic variables of the series and the predictors of urethral stricture recurrence after endoscopic urethrotomy. Material and methods: We retrospectively analysed 67 patients who underwent Sachse endoscopic urethrotomy between June 2006 and September 2014. Those patients who had previously undergone endoscopic urethrotomy or urethroplasty were excluded. The other patients who presented urethral stricture were included. We analysed age, weight, smoking habit, and cardiovascular risk factors, as well as the number, location, length and aetiology of the strictures, previous urethrotomies, vesical catheter duration and postsurgical dilatations. A univariate and multivariate analysis was conducted using the chi-squared test or Fisher's test and logistic regression to identify the variables related to recurrence. Results: Thirty-seven percent of the patients had a relapse. The majority of the patients were older than 60 years (56.7%), obese (74.6%), nonsmokers (88%) and had no cardiovascular factors (56.7%). The majority of the strictures were single (94%), 1 cm (82%), bulbar urethral (64.2%), iatrogenic (67.2%) and with no prior urethrotomy (89.6%). The majority of the patients carried a vesical catheter for 15 days (85.1%) and did not undergo postsurgical dilatation (65.7%). Only the length of the stricture was an independent risk factor for recurrence (P=.025; relative risk, 5.7; 95% CI 1.21-26.41). Conclusions: In the treatment of urethral strictures through endoscopic urethrotomy, a stricture length >1 cm is the only factor that predicts an increase in the risk of recurrence. We found no clinical or demographic factors that caused an increase in the incidence of recurrence. Similarly, technical factors such as increasing the bladder catheterisation time and urethral dilatations did not change the course of the disease. Their routine use is therefore unnecessary. (C) 2016 AEU. Published by Elsevier Espana, S.L.U. All rights reserved.

Más información

Título según WOS: ID WOS:000383933200009 Not found in local WOS DB
Título de la Revista: ACTAS UROLOGICAS ESPANOLAS
Volumen: 40
Número: 8
Editorial: ENE EDICIONES SL
Fecha de publicación: 2016
Página de inicio: 529
Página final: 533
DOI:

10.1016/j.acuro.2016.03.013

Notas: ISI