Guido Barbagli1,2, Marco Bandini3,4, Sofia Balò2, Francesco Montorsi5, Salvatore Sansalone6, Mauro De Dominicis7, Denis Butnaru8, Massimo Lazzeri9. 1. Center for Reconstructive Urethra Surgery, Arezzo, Rome, Milan, Italy. 2. Centro Chirurgico Toscano, Arezzo, Italy. 3. Centro Chirurgico Toscano, Arezzo, Italy. bandini.marco@hsr.it. 4. Unit of Urology, Urological Research Institute (URI), IRCCS Ospedale San Raffaele Hospital, Via Olgettina 60, Vita-Salute San Raffaele University, 20132, Milan, Italy. bandini.marco@hsr.it. 5. Unit of Urology, Urological Research Institute (URI), IRCCS Ospedale San Raffaele Hospital, Via Olgettina 60, Vita-Salute San Raffaele University, 20132, Milan, Italy. 6. Department of Surgical Sciences, University of Tor Vergata, Rome, Italy. 7. Department of Urology, Cristo Re Hospital, Rome, Italy. 8. Institute for Regenerative Medicine, Sechenov First Moscow State Medical University, Moscow, Russia. 9. Department of Urology, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milano, Italy.
Abstract
PURPOSE: The optimal harvesting site for oral grafting in patients with urethral strictures remain controversial, with no study investigating morbidity on large scale. We aimed to compare typical single cheek harvesting vs atypical lingual, labial or bilateral cheeks harvesting in terms of complications and patient-reported outcomes. METHODS: Within 827 patients treated at our referral center with oral graft urethroplasty, we compared typical vs atypical harvesting techniques. A self-administered, semiquantitative, non-validated questionnaire assessed early (10 days) and late (4 months) postoperative complications and patient-reported outcomes. A semiquantitative score was calculated according to patient responses, and it was used to assess early (6 questions) and late (13 questions) patient dissatisfaction status. Patients were defined early and/or late dissatisfied when they scored ≥ 7 and ≥ 10 at the early or late questionnaires, respectively. RESULTS: Between 1998 and 2019, our patients predominantly received typical single cheek harvesting (89% vs 11%), with + 1.5% increase rate per year (p < 0.001). Early and late dissatisfied patients were, respectively, 170 (23%) vs 39 (44%) and 59 (8%) vs 16 (18%) in the typical vs atypical groups. Atypical harvesting was associated with higher rates of early (Odds ratio [OR]: 2.34; 95% Confidence interval [CI] 1.44-3.75; p = 0.001) and late (OR: 2.37; 95%CI 1.22-4.42; p = 0.008) postoperative dissatisfaction. CONCLUSIONS: Typical single cheek harvesting was the preferred surgical option at our center and it was associated with negligible early and late rates of complications and patient's dissatisfaction. Conversely, atypical lingual, labial or bilateral cheeks harvesting was associated with higher complications and frequent patient dissatisfaction.
PURPOSE: The optimal harvesting site for oral grafting in patients with urethral strictures remain controversial, with no study investigating morbidity on large scale. We aimed to compare typical single cheek harvesting vs atypical lingual, labial or bilateral cheeks harvesting in terms of complications and patient-reported outcomes. METHODS: Within 827 patients treated at our referral center with oral graft urethroplasty, we compared typical vs atypical harvesting techniques. A self-administered, semiquantitative, non-validated questionnaire assessed early (10 days) and late (4 months) postoperative complications and patient-reported outcomes. A semiquantitative score was calculated according to patient responses, and it was used to assess early (6 questions) and late (13 questions) patient dissatisfaction status. Patients were defined early and/or late dissatisfied when they scored ≥ 7 and ≥ 10 at the early or late questionnaires, respectively. RESULTS: Between 1998 and 2019, our patients predominantly received typical single cheek harvesting (89% vs 11%), with + 1.5% increase rate per year (p < 0.001). Early and late dissatisfied patients were, respectively, 170 (23%) vs 39 (44%) and 59 (8%) vs 16 (18%) in the typical vs atypical groups. Atypical harvesting was associated with higher rates of early (Odds ratio [OR]: 2.34; 95% Confidence interval [CI] 1.44-3.75; p = 0.001) and late (OR: 2.37; 95%CI 1.22-4.42; p = 0.008) postoperative dissatisfaction. CONCLUSIONS: Typical single cheek harvesting was the preferred surgical option at our center and it was associated with negligible early and late rates of complications and patient's dissatisfaction. Conversely, atypical lingual, labial or bilateral cheeks harvesting was associated with higher complications and frequent patient dissatisfaction.
Authors: Michael R Markiewicz; Melissa A Lukose; Joseph E Margarone; Guido Barbagli; Kennon S Miller; Sung-Kiang Chuang Journal: J Urol Date: 2007-06-11 Impact factor: 7.450
Authors: Marco Bandini; Sasha Sekulovic; Bogdan Spiridonescu; Pramod Krishnappa; Anuj Deep Dangi; Milan Slavkovic; Vladislav Pesic; Andrea Salonia; Alberto Briganti; Francesco Montorsi; Rados Djinovic Journal: World J Urol Date: 2019-10-25 Impact factor: 4.226
Authors: Marco Bandini; Guido Barbagli; Riccardo Leni; Giuseppe O Cirulli; Giuseppe Basile; Sofia Balò; Francesco Montorsi; Salvatore Sansalone; Andrea Salonia; Alberto Briganti; Denis Butnaru; Massimo Lazzeri Journal: World J Urol Date: 2021-04-15 Impact factor: 4.226
Authors: Pankaj M Joshi; Marco Bandini; Sandeep Bafna; Vipin Sharma; Amey Patil; Shreyas Bhadranavar; Christian Yepes; Guido Barbagli; Francesco Montorsi; Sanjay B Kulkarni Journal: Eur Urol Open Sci Date: 2021-11-25