Literature DB >> 20727546

The use of uroflowmetry to diagnose recurrent stricture after urethral reconstructive surgery.

Bradley A Erickson1, Benjamin N Breyer, Jack W McAninch.   

Abstract

PURPOSE: The ability of uroflowmetry to diagnose recurrent stricture disease after urethroplasty has not been fully investigated.
MATERIALS AND METHODS: Our routine post-urethroplasty monitoring includes retrograde urethrogram and voiding cystourethrogram at 3 and 12 months, in addition to uroflowmetry at 3-month intervals for a year. All uroflowmetry data, including maximum flow rate, voided volume and voiding curve shape, as well as retrograde urethrogram/voiding cystourethrogram and voiding symptom data are stored in a prospectively maintained urethroplasty database that was analyzed for patients with postoperative retrograde urethrogram/voiding cystourethrogram and satisfactory uroflowmetry in the same period. Uroflowmetry data points and urinary symptoms were compared with corresponding findings on retrograde urethrogram/voiding cystourethrogram to determine the ability of uroflowmetry to predict recurrence.
RESULTS: A total of 278 men (68%) met study inclusion criteria, of whom 63 (23%) had recurrent stricture. Using a maximum flow rate of less than 10 ml per second resulted in only 54% test sensitivity to predict recurrence. The highest sensitivity and negative predictive value (each 99%) were achieved when all men with symptoms and/or obstructed flow curves were evaluated. Symptoms alone had a high specificity (87%), sensitivity (88%) and negative predictive value (95%).
CONCLUSIONS: Uroflowmetry is an adequate test to screen for postoperative stricture recurrence but only when the voiding curve and urinary symptoms are also evaluated. The flow rate alone does not appear to be a reliable tool to evaluate stricture recurrence.
Copyright © 2010 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

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Mesh:

Year:  2010        PMID: 20727546      PMCID: PMC3607664          DOI: 10.1016/j.juro.2010.06.015

Source DB:  PubMed          Journal:  J Urol        ISSN: 0022-5347            Impact factor:   7.450


  12 in total

1.  A comparison of sonourethrography and retrograde urethrography in evaluation of anterior urethral strictures.

Authors:  S Choudhary; P Singh; E Sundar; S Kumar; A Sahai
Journal:  Clin Radiol       Date:  2004-08       Impact factor: 2.350

2.  Noninvasive methods of diagnosing bladder outlet obstruction in men. Part 2: Noninvasive urodynamics and combination of measures.

Authors:  Mohammed Belal; Paul Abrams
Journal:  J Urol       Date:  2006-07       Impact factor: 7.450

3.  Reproducibility of uroflow measurement: experience during a double-blind, placebo-controlled study of doxazosin in benign prostatic hyperplasia.

Authors:  M R Feneley; W D Dunsmuir; J Pearce; R S Kirby
Journal:  Urology       Date:  1996-05       Impact factor: 2.649

4.  One-stage bulbar urethroplasty: retrospective analysis of the results in 375 patients.

Authors:  Guido Barbagli; Giorgio Guazzoni; Massimo Lazzeri
Journal:  Eur Urol       Date:  2008-01-22       Impact factor: 20.096

Review 5.  Stricture recurrence after urethroplasty: a systematic review.

Authors:  Joshua J Meeks; Bradley A Erickson; Michael A Granieri; Chris M Gonzalez
Journal:  J Urol       Date:  2009-08-14       Impact factor: 7.450

6.  Functional evaluation of anterior urethral strictures with combined antegrade and retrograde urethrography.

Authors:  B Asklin; A Nilsson; S Pettersson
Journal:  Scand J Urol Nephrol       Date:  1984

7.  Value of urinary flow patterns in the follow-up of children who underwent Snodgrass operation.

Authors:  Cevdet Kaya; Eyup Kucuk; Abdullah Ilktac; Metin Ozturk; M Ihsan Karaman
Journal:  Urol Int       Date:  2007       Impact factor: 2.089

8.  American Urological Association symptom index in the assessment of urethroplasty outcomes.

Authors:  A F Morey; J W McAninch; C P Duckett; R S Rogers
Journal:  J Urol       Date:  1998-04       Impact factor: 7.450

Review 9.  Imaging of male urethra.

Authors:  Pietro Pavlica; Libero Barozzi; Ilario Menchi
Journal:  Eur Radiol       Date:  2002-12-19       Impact factor: 5.315

10.  Functional evaluation of the results of hypospadias surgery with uroflowmetry.

Authors:  J T Garibay; C Reid; R Gonzalez
Journal:  J Urol       Date:  1995-08       Impact factor: 7.450

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  15 in total

1.  The International Prostate Symptom Score (IPSS) Is an Inadequate Tool to Screen for Urethral Stricture Recurrence After Anterior Urethroplasty.

Authors:  Christopher A Tam; Sean P Elliott; Bryan B Voelzke; Jeremy B Myers; Alex J Vanni; Benjamin N Breyer; Thomas G Smith; Christopher D McClung; Bradley A Erickson
Journal:  Urology       Date:  2016-04-21       Impact factor: 2.649

Review 2.  The cost of surveillance after urethroplasty.

Authors:  Uwais B Zaid; Mitchel Hawkins; Leslie Wilson; Jie Ting; Catherine Harris; Amjad Alwaal; Lee C Zhao; Allen F Morey; Benjamin N Breyer
Journal:  Urology       Date:  2015-03-25       Impact factor: 2.649

3.  Changes in uroflowmetry maximum flow rates after urethral reconstructive surgery as a means to predict for stricture recurrence.

Authors:  Bradley A Erickson; Benjamin N Breyer; Jack W McAninch
Journal:  J Urol       Date:  2011-09-23       Impact factor: 7.450

Review 4.  Management of the Recurrent Male Urethral Stricture.

Authors:  Uwais B Zaid; Garjae Lavien; Andrew C Peterson
Journal:  Curr Urol Rep       Date:  2016-04       Impact factor: 3.092

5.  Two-stage repair of proximal hypospadias with moderate to severe chordee using inner preputial skin graft: prospective evaluation of functional and cosmetic outcomes.

Authors:  Ahmed M Al-Adl; Ashraf M Abdel Aal; Tarek M El-Karamany; Yasser A Noureldin
Journal:  World J Urol       Date:  2020-01-14       Impact factor: 4.226

6.  Critical Analysis of the Use of Uroflowmetry for Urethral Stricture Disease Surveillance.

Authors:  Christopher A Tam; Bryan B Voelzke; Sean P Elliott; Jeremy B Myers; Christopher D McClung; Alex J Vanni; Benjamin N Breyer; Bradley A Erickson
Journal:  Urology       Date:  2016-02-10       Impact factor: 2.649

Review 7.  Patient-Reported Outcome Measures in Urethral Reconstruction.

Authors:  Nima Baradaran; Lindsay A Hampson; Todd C Edwards; Bryan B Voelzke; Benjamin N Breyer
Journal:  Curr Urol Rep       Date:  2018-05-17       Impact factor: 3.092

Review 8.  Evaluation of the outcomes after posterior urethroplasty.

Authors:  Daniel Liberman; Travis J Pagliara; Andrew Pisansky; Sean P Elliott
Journal:  Arab J Urol       Date:  2015-03-05

9.  Assessment of satisfaction and Quality of Life using self -reported questionnaires after urethroplasty: a prospective analysis.

Authors:  Eduardo Terra Lucas; Walter José Koff; Tiago Elias Rosito; Milton Berger; Tiago Bortolini; Brasil Silva Neto
Journal:  Int Braz J Urol       Date:  2017 Mar-Apr       Impact factor: 1.541

Review 10.  The role of noninvasive testing and questionnaires in urethroplasty follow-up.

Authors:  Gareth J Warren; Bradley A Erickson
Journal:  Transl Androl Urol       Date:  2014-06
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