Management of adult anterior urethral stricture disease: nationwide survey among urologists in The Netherlands

Leeuwen, M. van; Brandenburg, J.J.I.; Kok, Esther T.; Vijverberg, PL; Bosch, J. J. van der Werff ten

doi:10.1590/s1677-55382011000300023

Cited by 14 publications

(22 citation statements)

References 3 publications

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“…About one third of respondents claim to perform urethroplasties such as EPA and BMGU. In prior surveys, less than a sixth of respondents performed these operations [13][14][15] . It is arguable that these findings may indicate a change in practice over time or perhaps simply a different practice pattern specific to Germany.…”

Section: Discussionmentioning

confidence: 99%

“…The applied questions were based on prior performed surveys in the United States, the Netherlands and in Italy [13][14][15] . The questionnaire prompted respondent demographics, diagnostic work-up, treatment and follow-up of urethral strictures.…”

Section: Methodsmentioning

confidence: 99%

“…The adherence to these recommendations has been investigated in prior national surveys among urologists from the United States, the Netherlands and Italy [13][14][15] . These surveys revealed little experience with reconstructive surgery and implied unfamiliarity with the current literature and recommended treatment algorithms by expert panels [4,16] .…”

mentioning

confidence: 99%

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Management of Anterior Urethral Strictures in Adults: A Survey of Contemporary Practice in Germany

Rosenbaum

Reiß²,

Borgmann³

et al. 2017

Urol Int

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Introduction: Treatment methods of anterior urethral strictures in adults have undergone considerable changes in the recent past. Our goal was to determine national practice patterns among German urologists and to compare results with the results of prior international surveys. Methods: We conducted a survey on the management of urethral strictures among German urologists. Results: Eight hundred forty-five urologists, representing about 14.6% of German urologists, answered the survey. Most common procedures were direct vision internal urethrotomy (DVIU; 87.2%), blind internal urethrotomy (57.5%), dilatation (56.3%), ventral buccal mucosa graft urethroplasty (31.6%) and excision and primary anastomosis (28.9%). In case of a 3.5-cm bulbar stricture and in the case of a 1-cm bulbar stricture after 2 failed DVIUs, a consecutive urethroplasty was significantly more often favoured compared to transurethral treatment options (44.9 vs. 21.3% and 59.4 vs. 8.3%, both p < 0.001). Conclusion: Open urethral reconstruction reveals to be a more common method in practice nowadays. Adherence to recommended treatment algorithms improved in comparison to prior surveys.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Management of Anterior Urethral Strictures in Adults: A Survey of Contemporary Practice in Germany

Rosenbaum

Reiß²,

Borgmann³

et al. 2017

Urol Int

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“…Standard therapy is urethroplasty as it has higher long-term success rates compared to internal urethrotomy or urethral dilatation. Although urethroplasty is still underused, there is a trend towards an increased utilization [6][7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Urethroplasty and Quality of Life: Psychometric Validation of a Dutch Version of the Urethral Stricture Surgery Patient Reported Outcome Measures

Verla¹,

Waterloos²,

Lumen³

2017

Urol Int

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Purpose: The study aimed to translate the Urethral Stricture Surgery Patient Reported Outcome Measures (USS-PROM) questionnaire in Dutch. To validate this translated questionnaire, the study evaluates its psychometric properties in a different population, a different environment, and a different health care system. Questions about urinary incontinence and sexual functioning were added. Materials and Methods: Between December 2014 and January 2017, Dutch-speaking adult men scheduled for urethroplasty at Ghent University Hospital were prospectively enrolled in this study. Patients completed the USS-PROM before surgery, 3-6 months after surgery, and 1 year after surgery. Psychometric criteria included content validity, criterion validity, internal consistency, reproducibility, responsiveness, and floor and ceiling effects. (EC/2014/0438). Results: A total of 100 patients were included, 39 patients completed both the preoperative and the postoperative questionnaire, and 30 patients completed the USS-PROM twice within a short period of time in order to evaluate test-retest reliability. Pearson correlation coefficients showed no statistical significant correlation between lower urinary tract symptoms (LUTS) scores and maximum flow rates. Cronbach's α was 0.81 and 0.89, respectively, for the LUTS score and the summative Male Sexual Health Questionnaire Ejaculatory Dysfunction short form (MSHQ-EjD short form) score. The intraclass correlation coefficients ranged from 0.72 to 0.94. Significant changes were observed in all items except the MSHQ-EjD short form scores. All values exceeded the predefined thresholds. Conclusions: The Dutch version of the USS-PROM has adequate psychometric properties and is a valid instrument to assess patient-reported outcome measures in men undergoing urethroplasty.

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“…2,7,8 Of data retrieved from the Clinical Data Analysis and Reporting System (CDARS), from January 2015 to December 2016, only 50 cases of adult urethral reconstruction were performed in all public hospitals in Hong Kong. No designated reconstruction urologist and no consensus in the management of adult anterior urethral strictures could account for the underutilization of reconstruction surgery.…”

Section: Introductionmentioning

confidence: 99%

Anterior urethral strictures

Cheung

Lam

2018

Surgical Practice

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Aim: The aim of the present study was to determine the practice patterns in the management of anterior urethral strictures among urologists in Hong Kong. Patients and Methods: A 14-item questionnaire was delivered either directly or by mail to all 126 registered urologists in Hong Kong. Information including demographic data, number of anterior urethral strictures treated, diagnostic methods, treatment options and follow-up strategy were collected. The questionnaire also asked for the personal opinion about the treatment plan of two stricture case scenarios. Results: The response rate was 48 per cent. The majority (87 per cent) of urologists treated <10 anterior urethral strictures per year. Minimal invasive procedures, including urethral dilatation using metal sounds (77 per cent) or cystoscopy-guided (74 per cent) and direct visual internal urethrotomy (57 per cent), were more commonly performed by urologists to treat urethral strictures. The majority of urologists (82.6 per cent) performed less than five urethroplasties per year. In the two case scenarios of long bulbous urethral stricture and recurrent short urethral stricture, approximately 10 per cent of respondents would refer the cases to other urologists and approximately 75 per cent would choose to perform reconstructive surgeries. The remaining 15 per cent of respondents would choose minimally-invasive procedures for these strictures. Nearly two-thirds (62.3 per cent) of urologists believed that urethroplasty should be proposed only after failed endoscopic treatment. Workups for urethral stricture disease were consistent, while the modalities to access the outcome were highly heterogeneous. Conclusion: In Hong Kong, the majority of urologists choose to perform urethroplasty for long bulbous urethral strictures and recurrent short bulbous urethral strictures in a case scenario situation. However, in actual practice, most perform less than five urethroplasties per year. A small caseload, lack of experience and understanding of urethral reconstructive surgery means that most urologists in Hong Kong would hesitate to carry out primary urethroplasty in correctly-selected patients for whom primary reconstruction would have been the treatment of choice.

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Management of adult anterior urethral stricture disease: nationwide survey among urologists in The Netherlands

Cited by 14 publications

References 3 publications

Management of Anterior Urethral Strictures in Adults: A Survey of Contemporary Practice in Germany

Management of Anterior Urethral Strictures in Adults: A Survey of Contemporary Practice in Germany

Urethroplasty and Quality of Life: Psychometric Validation of a Dutch Version of the Urethral Stricture Surgery Patient Reported Outcome Measures

Anterior urethral strictures

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