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Postoperative urinary extravasation does not impact anterior urethroplasty surgical outcomes: a Latin American large cohort study

  • Urology - Original Paper
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Abstract

Objective

To determine the prevalence of postoperative urinary extravasation (POUE) following anterior urethroplasty, to analyze factors associated with its occurrence, and to study the impact of POUE on surgical success.

Materials and methods

Retrospective cohort study including all male patients who have undergone a urethroplasty at our center between 2011 and 2018. Subjects with posterior location stricture, those who did not undergo routine radiographic follow-up, or patients with inadequate follow-up were excluded. Urinary extravasation was defined as presence of evident contrast extravasation on the postoperative voiding cystourethrogram (VCUG).

Impact was determined as “need-for-reoperation”. Uni- and multivariate analysis were performed to determine clinical and demographic variables associated with occurrence of extravasation and postoperative stricture.

Results

A total of 783 men underwent a urethroplasty and 630 fulfilled inclusion criteria. Urinary extravasation prevalence was 12.2%, and there was a “need-for-reoperation” in 1.1% of cases. On uni- and multivariate analysis, greatest stricture length (HR: 1.07 (1–1.2), p = 0.05) and penile urethral location (HR: 2.29 (1.1–4.6), p = 0.021) showed to be POUE predictors. POUE did not show to be a risk factor for postoperative stricture (HR: 1.57, 95% CI (0.8–3), p = 0.173). However, reoperation group  showed to be a risk factor (HR: 6.6, 95% CI 1.4–31, p = 0.019).

Conclusions

Prevalence of POUE was 12.2%. Stricture length and penile urethral strictures were POUE predictors. POUE occurrence with successful conservative management did not appear to have impact on urethroplasty outcomes as it did not predict re-stricture. POUE was reoperation cause in 1.1% of total cases.

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Authors and Affiliations

  1. Genitourinary Reconstructive Surgery Sector, Department of Urology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina

    C. R. Giudice, S. A. Gil, T. Carminatti, E. Becher, I. P. Tobia & G. A. Favre

Authors
  1. C. R. Giudice
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  2. S. A. Gil
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  3. T. Carminatti
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  4. E. Becher
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  5. I. P. Tobia
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  6. G. A. Favre
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Contributions

CRG: project development/data analysis/manuscript writing/editing. SAG: project development/data collection or management/data analysis/manuscript writing/editing. TC: data collection or management. EB: manuscript writing/editing. IPT: project development/data analysis/manuscript writing/editing. GAF: project development/data analysis/manuscript writing/editing.

Corresponding author

Correspondence to S. A. Gil.

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The authors declare that they have no conflict of interest.

Ethical approval

Ethical approval was waived by the institutional research ethics committee of Hospital Italiano de Buenos Aires in view of the retrospective nature of the study and all the procedures being performed were part of the routine care. Reference Study number: 4002.

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Giudice, C.R., Gil, S.A., Carminatti, T. et al. Postoperative urinary extravasation does not impact anterior urethroplasty surgical outcomes: a Latin American large cohort study. Int Urol Nephrol 52, 1899–1905 (2020). https://doi.org/10.1007/s11255-020-02497-9

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  • DOI: https://doi.org/10.1007/s11255-020-02497-9

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