Single-surgeon series of delayed anastomotic urethroplasty for pelvic fracture urethral injury: an analysis of surgical and patient-reported outcomes of a ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-01-14

AUTHORS

Akio Horiguchi, Masayuki Shinchi, Kenichiro Ojima, Ayako Masunaga, Keiichi Ito, Tomohiko Asano, Eiji Takahashi, Fumihiro Kimura, Ryuichi Azuma

ABSTRACT

PurposeTo report our experience with delayed anastomotic urethroplasty for pelvic fracture urethral injury (PFUI) during the last 10 years and evaluate both surgical and patient-reported outcomes.MethodsRetrospective analysis of 115 patients undergoing delayed anastomotic urethroplasty for PFUI between 2008 and 2017 by a single surgeon (AH) was performed. Success was defined as a urethral lumen large enough for passage of a 17-Fr flexible cystoscope. We asked patients to complete questionnaires before (baseline) and 1 year after urethroplasty and compared by paired t and Wilcoxon signed-rank tests the answers to a question about LUTS-specific QOL and the health-related QOL indicated by EQ-5D index and visual analogue scores (EQVAS). Overall patient satisfaction 1 year after urethroplasty was also evaluated.ResultsUrethroplasty was successful in 108 patients (93.9%), and failed urethroplasty was significantly associated with greater intraoperative blood loss (p = 0.009) and smaller surgical experience (p = 0.018). Sixty-six patients (57.4%) completed questionnaires 1 year after urethroplasty, and 65 of those 66 (98.5%) were “satisfied” (36.4%) or “very satisfied” (62.1%) with the outcome of their urethroplasty. The LUTS-specific QOL scores (p < 0.0001), EQ-5D index scores (p < 0.0001), and EQVAS scores (p < 0.0001) all improved significantly after urethroplasty.ConclusionsDelayed anastomotic urethroplasty has a high success rate and significant beneficial effects on both LUTS-specific and health-related QOL, resulting in high patient satisfaction. Careful manipulation in a bloodless operative field by experienced surgeons could be the key to successful urethroplasty. More... »

PAGES

655-660

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00345-019-02630-z

DOI

http://dx.doi.org/10.1007/s00345-019-02630-z

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1111401709

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30643973


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