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尿道成形术后尿道狭窄复发的预测因素:尼日利亚乔斯大学教学医院的回顾性研究

Predictors of urethral stricture recurrence following urethroplasty: a retrospective review at the Jos University Teaching Hospital, Nigeria.

作者信息

Ofoha Chimaobi Gideon, Ramyil Venyir Mamhzi, Dakum Nuhu Kutan, Shu'aibu Samaila Ibrahim, Akpayak Idorenyin Cletus, Magnus Felix Echebiri, Swem Ushaaka, Oshagbemi Ayodele, Osunaiye Olutayo, Akhaine Julius

机构信息

Jos University Teaching Hospital (JUTH), Nigeria.

College of Medicine, University of Jos, Jos University Teaching Hospital, Nigeria.

出版信息

Pan Afr Med J. 2019 Apr 18;32:190. doi: 10.11604/pamj.2019.32.190.18504. eCollection 2019.

Abstract

INTRODUCTION

Incidence of urethral stricture recurrence ranges between 2% to 36.4% with 75% occurring within the first 6 months of surgery. Hence, they need to identify the predictors of recurrence following urethroplasty.

METHODS

This is a retrospective study involving patients that had urethroplasty from January 2008 to December 2017. Patients' records were reviewed. Analyzed data were for patients with a minimum follow up of one year from the time of urethroplasty and included aetiology of urethral stricture, presence of suprapubic cystostomy, prior urethral dilatation, urine M/C/S, site of urethral stricture, length of urethral stricture, type of urethroplasty, level of training of the surgeon, type of urethral stent used and duration of stenting. Analysis was done using SPSS version 23. P-value of < 0.05 was considered significant.

RESULTS

Eighty seven urethroplasties were done, from January 2008 to December 2017. However, only records of 44 patients were accessible. Twenty patients completed duration of follow up ≥ one year. Urethral stricture recurrence was defined as resurgence of Lower Urinary Tract Symptoms (LUTS) within one year. Median age of the patients was 39.5 (± 19) years. Urethral stricture recurrence rate was 25% with mean time to recurrence from urethroplasty of 5.3 (±3) months. The use of preoperative suprapubic catheter (SPC) for urinary diversion as well as urethroplasties performed by the consultants had a lower incidence of recurrence.

CONCLUSION

This study found urethral stricture recurrence of 25%. The level of training of surgeon vis-à-vis the expertise and experience seems to be an important factor, though not statistically significant in determining the outcome of urethroplasty.

摘要

引言

尿道狭窄复发率在2%至36.4%之间,75%的复发发生在手术的前6个月内。因此,他们需要确定尿道成形术后复发的预测因素。

方法

这是一项回顾性研究,涉及2008年1月至2017年12月期间接受尿道成形术的患者。对患者的记录进行了审查。分析的数据包括尿道狭窄的病因、耻骨上膀胱造瘘术的存在、先前的尿道扩张、尿液培养/药敏试验、尿道狭窄部位、尿道狭窄长度、尿道成形术类型、外科医生的培训水平、使用的尿道支架类型和支架置入持续时间。使用SPSS 23版进行分析。P值<0.05被认为具有统计学意义。

结果

2008年1月至2017年12月共进行了87例尿道成形术。然而,仅可获取44例患者的记录。20例患者完成了≥1年的随访。尿道狭窄复发定义为术后1年内下尿路症状(LUTS)再次出现。患者的中位年龄为39.5(±19)岁。尿道狭窄复发率为25%,从尿道成形术到复发的平均时间为5.3(±3)个月。术前使用耻骨上导管(SPC)进行尿液转流以及由顾问医生进行的尿道成形术复发率较低。

结论

本研究发现尿道狭窄复发率为25%。尽管在确定尿道成形术的结果方面没有统计学意义,但外科医生的培训水平与专业知识和经验似乎是一个重要因素。

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