Routine Imaging After Bulbar Urethral Reconstruction Does Not Impact Surgical Outcomes and May Not Be Necessary

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dc.contributor.authorCalvo, Carlos I.
dc.contributor.authorRourke, Keith F.
dc.date.accessioned2025-01-20T16:06:46Z
dc.date.available2025-01-20T16:06:46Z
dc.date.issued2024
dc.description.abstractOBJECTIVE To assess whether omitting routine post-operative imaging adversely impacts clinical outcomes after bulbar urethroplasty. Contrast imaging is commonly performed prior to catheter removal after urethroplasty but the clinical need for this is unclear.
dc.description.abstractMETHODS This was a matched, case-control analysis comparing patients undergoing routine voiding cystourethrogram (VCUG) prior to catheter removal after bulbar urethroplasty to patients without imaging. Patients were matched with respect to age, stricture etiology, length, and urethroplasty technique. Follow-up consisted of clinical assessment 3 weeks post-operatively for VCUG/catheter removal, cystoscopy at 3-4 months with clinical assessment annually. Outcome measures were 90-day complications (Clavien >= 2) and stricture recurrence (failure to pass a 16-Fr flexible cystoscope on follow-up). Chi-square and Kaplan-Meier analysis were conducted where appropriate.
dc.description.abstractRESULTS Hundred patients undergoing bulbar urethroplasty with VCUG prior to catheter removal were compared to 100 matched case controls without imaging. Groups did not differ with respect to failed endoscopic treatment (P = .82), prior urethroplasty (P = .09), comorbidities (P = .54), smoking (P = .42), or pre-operative bacteriuria (P = 1.00). The incidence of extravasation in the VCUG group was 2%. Overall 90-day complications were 9.5% and 15 patients developed recurrence with a median follow-up of 174 months. On chi-square analysis, 90-day complications did not differ between patients undergoing VCUG and those without (12% vs 7.0%; P = .34). On log-rank analysis, stricture recurrence did not differ between groups (P = .44).
dc.description.abstractCONCLUSION Routine imaging with VCUG after bulbar urethroplasty does not influence the risk of postoperative complications or stricture recurrence. Surgeons should consider avoiding this potentially unnecessary examination in routine clinical practice. UROLOGY 186: 41-47, 2024. (c) 2024 Elsevier Inc. All rights reserved.
dc.fuente.origenWOS
dc.identifier.doi10.1016/j.urology.2024.02.029
dc.identifier.eissn1527-9995
dc.identifier.issn0090-4295
dc.identifier.urihttps://doi.org/10.1016/j.urology.2024.02.029
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/89974
dc.identifier.wosidWOS:001301159400004
dc.language.isoen
dc.pagina.final47
dc.pagina.inicio41
dc.revistaUrology
dc.rightsacceso restringido
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleRoutine Imaging After Bulbar Urethral Reconstruction Does Not Impact Surgical Outcomes and May Not Be Necessary
dc.typeartículo
dc.volumen186
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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