Affirming Long-Term Outcomes After Contemporary Urethroplasty: The Adverse Impact of Increasing Stricture Length, Lichen Sclerosus, Radiation, and Infectious Strictures

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dc.contributor.authorCalvo, Carlos Ignacio
dc.contributor.authorFender, Kai
dc.contributor.authorHoy, Nathan
dc.contributor.authorRourke, Keith
dc.date.accessioned2025-01-20T17:07:07Z
dc.date.available2025-01-20T17:07:07Z
dc.date.issued2024
dc.description.abstractPurpose: There is a paucity of reported long-term outcomes after contemporary urethroplasty. Our objective is to determine the long-term success of modern urethroplasty and identify factors associated with stricture recurrence in this context. Materials and Methods: Patients undergoing urethroplasty from July 2003 to May 2013 with at least 100 months of follow-up were identified. Long-term outcomes including stricture recurrence and patient satisfaction were evaluated by review of regional/provincial electronic records and telephone interview. Urethroplasty failure was defined as a recurrent stricture (<16F) confirmed on cystoscopy. Cox regression was used to evaluate variables associated with long-term stricture recurrence. Results: A total of 733 patients were identified with >= 100 months follow-up. Median patient age was 45 years, stricture length was 4.7 cm, and 85.8% failed prior endoscopic treatment. At a median follow-up of 12.3 years, 89 recurrences were observed. Cumulative incidence of stricture recurrence was 6%, 10%, and 12% after 1, 5, and 10 years, respectively. From a patient-reported perspective, 89% of patients reported being satisfied with the outcome of surgery. On multivariable analyses, increasing stricture length (HR 1.1, 95% CI 1.05-1.15; P < .001) and stricture etiology (P < .001), in particular lichen sclerosus (HR 4.46, 95% CI 2.25-9.53), radiation (HR 4.25, 95% CI 1.65-10.9), and infectious strictures (HR 5.27, 95% CI 2.03-13.7), were independently associated with stricture recurrence. Conclusions: This study affirms the widely held belief that modern urethroplasty provides high long-term patency and patient-reported satisfaction. Patients with longer strictures as well as those with lichen sclerosus, radiation, and infectious etiologies have a higher hazard of stricture recurrence in the long term.
dc.description.funderAlberta Innovates - Health Solutions
dc.fuente.origenWOS
dc.identifier.doi10.1097/JU.0000000000003826
dc.identifier.eissn1527-3792
dc.identifier.issn0022-5347
dc.identifier.urihttps://doi.org/10.1097/JU.0000000000003826
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/90843
dc.identifier.wosidWOS:001183735800017
dc.issue.numero3
dc.language.isoen
dc.pagina.final464
dc.pagina.inicio455
dc.revistaJournal of urology
dc.rightsacceso restringido
dc.subjecturethral stricture
dc.subjecturethral diseases
dc.subjectoutcome assessment
dc.subjectpatient satisfaction
dc.subjectreconstructive surgery
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleAffirming Long-Term Outcomes After Contemporary Urethroplasty: The Adverse Impact of Increasing Stricture Length, Lichen Sclerosus, Radiation, and Infectious Strictures
dc.typeartículo
dc.volumen211
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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