Viers BR, et al. – The aim of this study was to explore the correlation between urethroplasty delay, endoscopic treatments, and subsequent reconstructive outcomes. It has been validated that urethroplasty delay is common and often correlated with symptomatic events managed by repetitive urethral manipulations. In addition, endoscopic treatments appear to lengthen strictures and increase complexity of repair.

Methods

• Between 2007-2014, researchers reviewed men undergoing primary bulbar urethroplasty.
• They excluded prior urethroplasty, penile and/or membranous strictures, and cases with incomplete data.
• Thereafter, men were stratified by urethroplasty delay of <5, 5-10, and >10 years from diagnosis.

Results

• They examined a sum of 278 primary bulbar urethroplasty cases with complete data.
• In this study, median time between stricture diagnosis and reconstruction was 5 years (IQR 2-10).
• In this analysis, patients underwent an average 0.9 (± 2.4) endoscopic procedures per year of delay.
• As per the data, relative to <5 and 5-10 years, delay >10 years was correlated with more endoscopic treatments (median 1 vs 2 vs 5), repetitive self-dilations (13% vs 14% vs 34%), strictures >2 cm (40% vs 39% vs 56%), and complex reconstructive techniques (17% vs 17% vs 34%).
• The results of this study showed that increasing number of endoscopic treatments (OR 1.06; p=0.003) was independently correlated with strictures >2 cm, which had worse 24-month stricture-free survival compared to shorter strictures (83% vs 96%; p=0.0003).
• The data showed that each consecutive DVIU was independently correlated with risk of urethroplasty failure (HR 1.19; p=0.02).