Clemens M Rosenbaum1, Marianne Schmid2,3, Tim A Ludwig2, Luis A Kluth2, Roland Dahlem2, Margit Fisch2, Sascha Ahyai2,3. 1. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. rosenbaumclemens@gmail.com. 2. Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. 3. Department of Urology, University Medical Centre Göttingen, Göttingen, Germany.
Abstract
OBJECTIVES: To determine the success rate, oral morbidity and functional outcomes of redo buccal mucosa graft urethroplasty (BMGU) for treatment of stricture recurrence after previous BMGU. PATIENTS AND METHODS: We included 50 patients who underwent redo BMGU between February 2009 and September 2014. Patients' charts and non-validated questionnaires were reviewed. The primary endpoint was success rate, defined as stricture-free survival. Stricture recurrence was defined as any postoperative claims of catheterization, dilatation, urethrotomy or repeat urethroplasty, or a maximum urinary flow rate <15 mL/s, and a stricture was consecutively verified in a combined cysto-urethrogram or cystoscopy at annual follow-up visit. The secondary endpoint was oral morbidity. Additional endpoints were erectile function, urinary continence and patients' satisfaction. RESULTS: Redo BMGU was performed for bulbar (71.4%) or penile (28.6%) recurrent strictures. The mean (median; range) follow-up was 25.6 (15.5; 3-70) months. Stricture recurrence occurred in 18.0% of patients within a mean (median; range) of 13.8 (9.0; 3-36) months. Stricture-free survival at 12, 24 and 36 months was 91.2, 86.2 and 80.8%, respectively. The majority of the patients (97.0%) reported no or only mildly changed salivation or problems in opening of the mouth. Severe or very severe oral numbness occurred in 13.5% of patients. Oral problems in daily life were a moderate or severe burden to 13.6 and 2.7% of the patients, respectively, while 75.0% of the patients reported improved quality of life compared with preoperative status. CONCLUSIONS: The success rate and oral morbidity of redo BMGU are almost the same as outcomes of primary BMGU. Oral numbness was the most frequently reported oral disorder.
OBJECTIVES: To determine the success rate, oral morbidity and functional outcomes of redo buccal mucosa graft urethroplasty (BMGU) for treatment of stricture recurrence after previous BMGU. PATIENTS AND METHODS: We included 50 patients who underwent redo BMGU between February 2009 and September 2014. Patients' charts and non-validated questionnaires were reviewed. The primary endpoint was success rate, defined as stricture-free survival. Stricture recurrence was defined as any postoperative claims of catheterization, dilatation, urethrotomy or repeat urethroplasty, or a maximum urinary flow rate <15 mL/s, and a stricture was consecutively verified in a combined cysto-urethrogram or cystoscopy at annual follow-up visit. The secondary endpoint was oral morbidity. Additional endpoints were erectile function, urinary continence and patients' satisfaction. RESULTS: Redo BMGU was performed for bulbar (71.4%) or penile (28.6%) recurrent strictures. The mean (median; range) follow-up was 25.6 (15.5; 3-70) months. Stricture recurrence occurred in 18.0% of patients within a mean (median; range) of 13.8 (9.0; 3-36) months. Stricture-free survival at 12, 24 and 36 months was 91.2, 86.2 and 80.8%, respectively. The majority of the patients (97.0%) reported no or only mildly changed salivation or problems in opening of the mouth. Severe or very severe oral numbness occurred in 13.5% of patients. Oral problems in daily life were a moderate or severe burden to 13.6 and 2.7% of the patients, respectively, while 75.0% of the patients reported improved quality of life compared with preoperative status. CONCLUSIONS: The success rate and oral morbidity of redo BMGU are almost the same as outcomes of primary BMGU. Oral numbness was the most frequently reported oral disorder.
Authors: Wesley Verla; Marjan Waterloos; Anne-Françoise Spinoit; Sarah Buelens; Elise De Bleser; Willem Oosterlinck; Francisco Martins; Enzo Palminteri; Achilles Ploumidis; Nicolaas Lumen Journal: Biomed Res Int Date: 2020-01-31 Impact factor: 3.411
Authors: E Morán; M A Bonillo; L Fernández-Estevan; E Martínez-Cuenca; S Arlandis; E Broseta; F Boronat Journal: World J Urol Date: 2018-06-21 Impact factor: 4.226
Authors: Keith F Rourke; Blayne Welk; Ron Kodama; Greg Bailly; Tim Davies; Nancy Santesso; Philippe D Violette Journal: Can Urol Assoc J Date: 2020-10 Impact factor: 2.052