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dc.contributor.author | Policastro, Connor G. | |
dc.contributor.author | Simhan, Jay | |
dc.contributor.author | Martins, Francisco | |
dc.contributor.author | Lumen, Nicolaas | |
dc.contributor.author | Venkatesan, Krishnan | |
dc.contributor.author | Angulo Cuesta, Javier | |
dc.contributor.author | Gupta, Shubham | |
dc.contributor.author | Rusilko, Paul | |
dc.contributor.author | Ramírez Pérez, Erick Alejandro | |
dc.contributor.author | Redger, Kirk | |
dc.contributor.author | Flynn, Brian J. | |
dc.contributor.author | Hughes, Michael | |
dc.contributor.author | Blakely, Stephen | |
dc.contributor.author | Nikolavsky, Dmitriy | |
dc.date.accessioned | 2022-01-13T20:10:18Z | |
dc.date.available | 2022-01-13T20:10:18Z | |
dc.date.issued | 2021 | |
dc.identifier.citation | Policastro, C. G., Simhan, J., Martins, F. E., Lumen, N., Venkatesan, K., Angulo, J., Gupta, S., Rusilko, P., Ramírez Pérez, E. A., Redger, K., Flynn, B. J., Hughes, M., Blakely, S., & Nikolavsky, D. (2021). A multi-institutional critical assessment of dorsal onlay urethroplasty for post-radiation urethral stenosis. World Journal of Urology, 39(7), 2669-2675. https://doi.org/10.1007/s00345-020-03446-y | spa |
dc.identifier.issn | 0724-4983 | |
dc.identifier.issn | 1433-8726 | |
dc.identifier.uri | http://hdl.handle.net/11268/10562 | |
dc.description.abstract | Purpose: To critically evaluate a multi-institutional patient cohort undergoing Dorsal-Onlay Buccal Mucosal Graft Urethroplasty (D-BMGU) for recurrent post-radiation posterior urethral stenosis. Methods: Retrospective multi-institutional review of patients with posterior urethral stenosis from 10 institutions between 2010-2019 was performed. Patients with at least 1-year follow-up were assessed. Patient demographics, stenosis characteristics, peri-operative outcomes, and post-operative clinical and patient-reported outcomes were analyzed. The primary outcomes were stenosis recurrence and de-novo stress urinary incontinence (SUI). Secondary outcomes were changes in voiding, sexual function, and patient-reported satisfaction. Results: Seventy-nine men with post-radiation urethral stenosis treated with D-BMGU met inclusion criteria. Median age and stenosis length were 72 years, (IQR 66-75), and 3.0 cm (IQR 2.5-4 cm), respectively. Radiation modalities included: 36 (45.6%) external beam radiotherapy (EBRT), 13 (16.5%) brachytherapy (BT), 10 (12.7%) combination EBRT/BT, and 20 (25.3%) EBRT/radical prostatectomy. At a median follow-up of 21 months (IQR 13-40), 14 patients (17.7%) had stenosis recurrence. Among 37 preoperatively-continent patients, 3 men (8.1%) developed de-novo SUI following dorsal onlay urethroplasty. Of 29 patients with preoperative SUI all but one remained incontinent post-operatively (96.6%). Following repair, patients experienced significant improvement in PVR (92.5 to 26 cc, p = 0.001) and Uroflow (4.6 to 15.9 cc/s, p = 0.001), and high overall satisfaction, with 91.9% reporting a GRA of + 2 or better). Conclusion: Dorsal onlay buccal mucosa graft urethroplasty is a safe and feasible technique in patients with post-radiation posterior urethral stenosis. This non-transecting approach may confer low rates of de-novo SUI. Further research is needed to compare this technique with excisional urethroplasty. | spa |
dc.description.sponsorship | Sin financiación | spa |
dc.language.iso | eng | spa |
dc.subject.other | Estrechez uretral | spa |
dc.subject.other | Incontinencia urinaria de esfuerzo | spa |
dc.title | A multi-institutional critical assessment of dorsal onlay urethroplasty for post-radiation urethral stenosis | spa |
dc.type | article | spa |
dc.description.impact | 3.661 JCR (2021) Q2, 31/90 Urology & Nephrology | spa |
dc.description.impact | 1.003 SJR (2021) Q1, 14/108 Urology | spa |
dc.description.impact | No data IDR 2021 | spa |
dc.identifier.doi | 10.1007/s00345-020-03446-y | |
dc.rights.accessRights | closedAccess | spa |
dc.subject.unesco | Ciencias médicas | spa |
dc.subject.unesco | Investigación médica | spa |
dc.description.filiation | UEM | spa |
dc.peerreviewed | Si | spa |
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