Improvement in Storage Related Lower Urinary Tract Symptoms following Urethroplasty: A Prospective Cohort Study

Hoare, Dylan; Bekkema, Jordan; Rourke, Keith

doi:10.1097/ju.0000000000001514

Cited by 5 publications

(13 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…One study of MUSD, found the most prevalent pre-operative symptoms were urinary frequency, urgency and nocturia with rates of 52.5, 48.8 and 41.6% respectively. [18] Limitations of our study include a small sample size and limited follow-up similar to other contemporary studies, and being underpowered to allow statistical comparisons. In terms of follow-up, though we had a broad range, including our more recent cases brought down our followup (median 12.2 months and mean 23 months).…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Female urethroplasty with dorsal onlay buccal mucosal graft: a single institution experience

et al. 2023

View full text Add to dashboard Cite

Purpose Female urethral stricture disease is frequently unrecognized or misdiagnosed, with controversy in the literature regarding the definition of strictures and approach to management. The purpose of this study is to report our institutional experience with female urethroplasty and add our experience to the growing body of research. Methods We performed a retrospective review of patients undergoing female urethroplasty with dorsal onlay BMG at the University of Colorado between March 2015 and December 2021 performed by two surgeons (BF and JO). The primary outcome measure was surgical success, defined as no stricture recurrence. The secondary outcome measure was the incidence of de novo urinary incontinence. Results 23 patients were included in our data analysis. The median duration of lower urinary tract symptoms prior to urethroplasty was 16 years. 87% had undergone previous dilations. At a median follow-up of 12.2 months (range 1–81 months), four patients required a secondary procedure for obstruction with an overall success rate of 83%. One patient developed de novo stress urinary incontinence and one patient developed urge urinary incontinence. Subgroup analysis was performed comparing the patients that developed stricture recurrence (N = 4) to those that did not (N = 19). Those with stricture recurrence had a longer duration of symptoms and more dilations prior to urethroplasty. Conclusion Female urethroplasty with BMG is effective at treating female urethral stricture disease, with excellent outcomes at over a year of follow-up and minimal risk of stress incontinence postoperatively.

show abstract

Section: Discussionmentioning

confidence: 98%

“…One study of MUSD, found the most prevalent pre-operative symptoms were urinary frequency, urgency and nocturia with rates of 52.5, 48.8 and 41.6% respectively. [ 18 ]…”

Section: Discussionmentioning

confidence: 99%

Female urethroplasty with dorsal onlay buccal mucosal graft: a single institution experience

et al. 2023

View full text Add to dashboard Cite

show abstract

“…However, recent evidence suggests that storage symptoms also improve significantly following urethroplasty. 19 Additionally, 10.1% of patients had no improvement in UQOL, and this could be due to no improvement in voiding symptoms or other additional factors that are not captured in the IPSS. Of the patients 2.3% had no improvement in UQOL despite having a significant improvement in voiding symptoms, and factors such as pain, which are not captured in the IPSS, may be contributing to this.…”

Section: Discussionmentioning

confidence: 99%

“…This again may reflect the duration of partial obstruction adversely impacting detrusor function, given that hypospadias is commonly associated with urethral stricture and given that the congenital nature of the condition may have a longer duration of obstruction with heightened risk of secondary detrusor dysfunction. 19…”

Section: Discussionmentioning

confidence: 99%

“…7,17,18 In our study, patients showed a significant improvement in IPSS from a mean preoperative IPSS of 20.3 to a mean postoperative IPSS of 5.4, which is consistent with other studies in the literature. 17, 19 Erickson et al found a mean improvement in IPSS score following urethroplasty of approximately 13 points. 8 Although they had found the IPSS to be a relatively poor standalone screening tool for urethral stricture disease recurrence, they did not evaluate or characterize those who experienced no significant improvement in IPSS ("LUTS failure") following urethroplasty.…”

Section: Impact Of Urethroplasty On Lower Urinary Tract Symptomsmentioning

confidence: 99%

See 1 more Smart Citation

Urinary Symptom Nonresponse (“LUTS Failure”) after Urethroplasty: Incidence and Associations

2021

View full text Add to dashboard Cite

Purpose:An ill-defined proportion of patients undergoing urethroplasty fail to experience improvement in lower urinary tract symptoms (LUTS) despite being stricture-free. We aim to identify the incidence, associations and causes of “LUTS failure” after urethroplasty.Materials and Methods:Patients undergoing urethroplasty over a 6-year period were offered enrollment in a prospective study examining urinary function after urethroplasty. Patients were assessed preoperatively and 6 months postoperatively using the International Prostate Symptom Score (IPSS) and cystoscopy. “LUTS failure” was defined as ≤3-point improvement in IPSS despite an anatomically successful urethroplasty. Multivariable logistic regression was utilized to evaluate the association between patient factors and “LUTS failure.”Results:Of 365 patients meeting inclusion criteria, mean postoperative IPSS (20.3 vs. 5.4, p <0.0001) and median urinary quality of life (UQOL; 5 vs. 1; p <0.0001) were significantly improved. Despite being stricture-free, 7.7% of patients reported “LUTS failure” and 10.1% reported UQOL nonresponse. On multivariable logistic regression, increasing age (OR 1.04, 95% CI 1.01–1.06; p=0.006) and hypospadias (OR 18.2, 95% CI 2.1–156.0; p=0.008) were associated with “LUTS failure,” while stricture location (p=0.76), length (p=0.14), previous urethroplasty (p=0.96), failed endoscopic treatment (p=0.17), type of urethroplasty (p=0.93) and other etiologies were not. Qualitatively, the most likely causes of “LUTS failure” were detrusor underactivity (39.3%), overactivity (21.4%), pelvic floor dysfunction (21.4%) or benign prostatic hyperplasia (14.3%). Only increasing age was associated with UQOL nonresponse (OR 1.03, 95% CI 1.01–1.07; p=0.02).Conclusions:While many patients experience improved voiding function after urethroplasty, 7.7% experience “LUTS failure” and 10.1% report UQOL nonresponse. Both occurrences are independently associated with increasing patient age and most commonly related to detrusor underactivity.

show abstract

How Do We Assess Success After Surgical Management of Urethral Stricture Disease?

Blair

2023

Curr Bladder Dysfunct Rep

View full text Add to dashboard Cite

Improvement in Storage Related Lower Urinary Tract Symptoms following Urethroplasty: A Prospective Cohort Study

Cited by 5 publications

References 0 publications

Female urethroplasty with dorsal onlay buccal mucosal graft: a single institution experience

Female urethroplasty with dorsal onlay buccal mucosal graft: a single institution experience

Urinary Symptom Nonresponse (“LUTS Failure”) after Urethroplasty: Incidence and Associations

How Do We Assess Success After Surgical Management of Urethral Stricture Disease?

Contact Info

Product

Resources

About