Urethroplasty after urethral urolume stent: An international multicenter experience

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dc.contributor.author Angulo Cuesta, Javier
dc.contributor.author Kulkarni, Sanjay
dc.contributor.author Pankaj, Joshi
dc.contributor.author Nikolavsky, Dmitriy
dc.contributor.author Suarez, Pedro
dc.contributor.author Belinky, Javier
dc.contributor.author Virasoro, Ramón
dc.contributor.author DeLong, Jessica
dc.contributor.author Martins, Francisco
dc.contributor.author Santucci, R.
dc.contributor.author Et al.
dc.date.accessioned 2018-08-13T12:16:58Z
dc.date.available 2018-08-13T12:16:58Z
dc.date.issued 2018
dc.identifier.citation Angulo, J. C., Kulkarni, S., Pankaj, J., Nikolavsky, D., Suarez, P., Belinky, J., ... & Santucci, R. (2018). Urethroplasty after urethral urolume stent: An international multicenter experience. Urology, 118, 213-219. https://doi.org/10.1016/j.urology.2018.04.031. spa
dc.identifier.issn 0090-4295
dc.identifier.uri http://hdl.handle.net/11268/7370
dc.description.abstract To evaluate the outcomes and factors affecting success of urethroplasty in patients with stricture recurrence after Urolume urethral stent. Material and Methods: This is a retrospective international multicenter study on patients treated with urethral reconstruction after Urolume stent. Stricture and stent length, time between urethral stent insertion and urethroplasty, age, mode of stent retrieval, type of urethroplasty, complications and baseline, and posturethroplasty voiding parameters were analyzed. Successful outcome was defined as standard voiding, without need of any postoperative adjunctive procedure. Results: Sixty-three patients were included. Stent was removed at urethroplasty in 61 patients. Reconstruction technique was excision and primary anastomosis in 14 (22.2%), dorsal onlay buccal mucosa graft (BMG) in 9 (14.3%), ventral onlay BMG in 6 (9.5%), dorsolateral onlay BMG in 9 (14.3%), ventral onlay plus dorsal inlay BMG in 3 (4.8%), augmented anastomosis in 5 (7.9%), pedicled flap urethroplasty in 6 (9.5%), 2-stage procedure in 4 (6.4%), and perineal urethrostomy in 7(11.1%). Success rate was 81% at a mean 59.7 ± 63.4 months. Dilatation or internal urethrotomy was performed in 10 (15.9%) and redo-urethroplasty in 5 (7.9%). Total International Prostate Symptom Score, quality of life, urine maximum flow, and postvoid residual significantly improved (P <.0001). Complications occurred in 8 (12.7%), all Clavien-Dindo ≤2. Disease-free survival rate after reconstruction was 88.1%, 79.5%, and 76.7% at 1, 3, and 5 years, respectively. Explant of individual strands followed by onlay BMG is the most common approach and was significantly advantageous over the other techniques (P = .018). Conclusion: Urethroplasty in patients with Urolume urethral stents is a viable option of reconstruction with a high success rate and very acceptable complication rate. Numerous techniques are viable; however, urethral preservation, tine-by-tine stent extraction, and use of BMG augmentation produced significantly better outcomes. spa
dc.description.sponsorship SIN FINANCIACIÓN spa
dc.language.iso eng spa
dc.title Urethroplasty after urethral urolume stent: An international multicenter experience spa
dc.type article spa
dc.description.impact 2.300 JCR (2017) Q2, 32/76 Urology & Nephrology spa
dc.identifier.doi 10.1016/j.urology.2018.04.031
dc.rights.accessRights closedAccess spa
dc.subject.uem Stents spa
dc.subject.uem Uretra spa
dc.subject.uem Micción spa
dc.subject.unesco Cirugía spa
dc.subject.unesco Hombre spa
dc.description.filiation UEM spa
dc.peerreviewed Si spa

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