Division of Urology, University of Alberta, Edmonton, Alberta, Canada.
Division of Urology, University of Alberta, Edmonton, Alberta, Canada.
Urology. 2019 Oct;132:189-194. doi: 10.1016/j.urology.2019.07.013. Epub 2019 Jul 18.
To determine the frequency of complications related to urethral stricture and identify clinical factors associated with them.
Of 1851 patients with a suspected diagnosis of urethral stricture referred to a single urologist from 2005 to 2016 were retrospectively reviewed. Clinical variables included complications directly related to urethral stricture at the time of patient presentation, associated signs/symptoms, patient age, stricture length, location, and etiology. Complications considered significant were acute urinary retention or difficult catheterization requiring emergent urologic intervention or renal failure, urosepsis, or urethral abscess directly related to stricture. Patients without complete data were excluded from study. The occurrence of complications was compared in relation to patient age, symptoms, stricture length, location, and etiology using binary logistic regression.
Of 1023 patients meeting inclusion criteria, mean age was 48.0 years and mean stricture length was 5.0 cm (1-18). Of 40.6% (415) of patients experienced at least one complication directly related to urethral stricture including acute urinary retention (32.6%), difficult catheterization (16.0%), urethral abscess/urosepsis (5.0%), or renal failure (3.1%). On multivariate analysis, stricture length (cm) (odds ratio [OR] 1.1; 95% confidence interval [CI] 1.1-1.2, P = .01), lack of reported lower urinary tract symptoms (OR 3.8, 95%CI 1.9-7.3, P <.0001), posterior stenosis (OR 3.0, 95%CI 1.3-6.8, P = .01), and trauma-related strictures (OR 1.6, 95% CI 1.1-2.4, P = .02) were associated with complications. Lastly, 7.0% of patients experienced complications deemed to be life-threatening.
Urethral stricture is frequently a morbid condition. Patients with longer strictures, posterior stenoses, absence of preceding lower urinary tract symptoms and traumatic strictures are at highest risk for complications related to urethral stricture and should likely be directed toward more definitive treatment.
确定与尿道狭窄相关并发症的发生频率，并确定与这些并发症相关的临床因素。
回顾性分析 2005 年至 2016 年间，1851 例疑似尿道狭窄患者的临床资料。临床变量包括患者就诊时与尿道狭窄直接相关的并发症、相关体征/症状、患者年龄、狭窄长度、位置和病因。将急性尿潴留或需要紧急泌尿科干预的困难导尿或肾衰竭、尿脓毒症或与狭窄直接相关的尿道脓肿等需要治疗的并发症视为显著并发症。有不完整数据的患者被排除在研究之外。使用二项逻辑回归比较患者年龄、症状、狭窄长度、位置和病因与并发症发生的关系。
符合纳入标准的 1023 例患者中，平均年龄为 48.0 岁，平均狭窄长度为 5.0cm（1-18）。40.6%（415 例）的患者至少发生了一次与尿道狭窄直接相关的并发症，包括急性尿潴留（32.6%）、困难导尿（16.0%）、尿道脓肿/尿脓毒症（5.0%）或肾衰竭（3.1%）。多变量分析显示，狭窄长度（cm）（比值比[OR]1.1；95%置信区间[CI]1.1-1.2，P=0.01）、无下尿路症状报告（OR 3.8，95%CI 1.9-7.3，P<.0001）、后尿道狭窄（OR 3.0，95%CI 1.3-6.8，P=0.01）和创伤性狭窄（OR 1.6，95%CI 1.1-2.4，P=0.02）与并发症相关。最后，7.0%的患者发生了危及生命的并发症。
尿道狭窄通常是一种严重的疾病。狭窄长度较长、后尿道狭窄、无先前下尿路症状和创伤性狭窄的患者发生与尿道狭窄相关的并发症的风险最高，因此可能需要更明确的治疗。
