TY - JOUR AU - Kinnaird, Adam S. AU - Levine, Max A. AU - Ambati, Druvtej AU - Zorn, Jeff D. AU - Rourke, Keith Francis PY - 2014/05/21 Y2 - 2024/03/29 TI - Stricture length and etiology as preoperative independent predictors of recurrence after urethroplasty: A multivariate analysis of 604 urethroplasties JF - Canadian Urological Association Journal JA - CUAJ VL - 8 IS - 5-6 SE - Original Research DO - 10.5489/cuaj.1661 UR - https://cuaj.ca/index.php/journal/article/view/1661 SP - e296-300 AB - <p><strong>Introduction: </strong>We determine the preoperative identifiable risk factors during staging that predict stricture recurrence after urethroplasty.</p><p><strong>Methods: </strong>We conducted a retrospective review of all urethroplasties performed at a Canadian tertiary referral centre from 2003 to 2012. Failure was defined as a recurrent stricture &lt;16 Fr oncystoscopic assessment. Multivariate analysis was calculated by Cox proportional hazard regression.</p><p><strong>Results:</strong> In total, 604 of 651 (93%) urethroplasties performed had adequate data with a mean follow-up of 52 months. Overall urethral patency was 90.7% with failures occurring between 2 weeks and 77 months postoperatively. The average time to recurrence was 11.7 months, with most patients with recurrence within 6 months (42/56; 75%). Multivariate regression identified Lichen sclerosus, iatrogenic, and infectious etiologies to be independently associated with stricture recurrence with hazard ratios (HR) (95% confidence interval) of 5.9 (2.1-16.5; p ≤ 0.001), 3.4 (1.2-10; p = 0.02), and 7.3 (2.3-23.7; p ≤ 0.001), respectively. Strictures ≥5 cm recurred significantly more often (13.8% vs. 5.9%) with a HR 2.3 (1.2-4.5; p ≤ 0.01). Comorbidities, smoking, previous urethroplasty, stricture location and an age ≥50 were not associated with recurrence.</p><p><strong>Conclusion: </strong>Urethroplasty in general is an excellent treatment for urethral stricture with patency rates approaching 91%. While recurrences occur over 6 years after surgery, most (75%) recur within the first 6 months. Long segment strictures (≥5 cm), as well as Lichen sclerosus, infectious and iatrogenic etiologies, are associated with increased risk of recurrence. Limitations include the retrospective, single-centre nature of the study and the 7% loss to follow-up due to the centre being a regional referral one.</p> ER -