To describe the characteristics, management, and functional outcomes of patients with synchronous urethral stricture disease (SUSD) utilizing a multi-institutional cohort.
Data were collected and assessed from a prospectively maintained, multi-institutional database. Patients who underwent anterior urethroplasty for USD were included and stratified by the presence or absence of SUSD. USD location and etiology were classified according to the TURNS LSE Anterior Urethral Stricture Classification System. Anterior urethroplasty techniques were recorded for both strictures. Functional failure was compared between groups.
1,983 patients were identified, of whom, 137/1983 (6.9%) had SUSD. The mean primary stricture length for patients with SUSD was 3.5 cm and 2.6 cm for the secondary stricture. Twelve anterior urethroplasty technique combinations were utilized in treating the 27 different combinations of SUSD. Functional failure was noted in 18/137 (13.1%) patients with SUSD versus 192/1846 (10.4%) patients with solitary USD, p=0.3. SUSD was not associated with increased odds of functional failure. S classifications: S1b, p=0.003, S2a, p=0.001, S2b, p=0.01 and S2c, p=0.02 and E classifications: E3a, p=0.004 and E6, p=0.03, were associated with increased odds of functional failure.
Repair of SUSD in a single setting does not increase the risk of functional failure compared to patients with solitary USD. Increasing S classification, S1b through S2c and E classifications E3a and E6 were associated with increased functional failure. This reinforces the importance of the TURNS LSE Anterior Urethral Stricture Classification System as a necessary tool in large scale multi-institutional analysis when assessing highly heterogenous patient populations.
Urology. 2023 Sep 04 [Epub ahead of print]
Marcus L Jamil, Alexandra Hamsa, Shawn Grove, Eric Y Cho, Nejd F Alsikafi, Benjamin N Breyer, Joshua A Broghammer, Jill C Buckley, Sean P Elliott, Bradley A Erickson, Jeremy B Myers, Andrew C Peterson, Keith F Rourke, Bryan B Voelzke, Lee C Zhao, Alex J Vanni
Lahey Hospital and Medical Center, Burlington, MA., University of Minnesota, Minneapolis, MN., University of California San Diego, San Diego., Uropartners, Gurnee, IL., University of San Francisco, San Francisco, CA., University of Kansas, Kansas City, KS, CA., University of Iowa, Iowa City, IA., University of Utah, Salt Lake City, UT., Department of Urology, Duke University, Durham, North Carolina., Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB., Spokane Urology, Spokane, WA., New York University, New York City, NY., Lahey Hospital and Medical Center, Burlington, MA. Electronic address: .