Prebay Zachary J, Ostrovsky Adam M, Buck Matthew, Chung Paul H
Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
J Clin Med. 2023 Mar 5;12(5):2055. doi: 10.3390/jcm12052055.
We queried a global database to understand re-intervention rates following urethroplasty with the goal of evaluating whether they align with previously published data.
Using the TriNetX database and Common Procedural Terminology (CPT) and International Classification of Diseases-10 (ICD) codes, we identified adult male patients with urethral stricture disease (ICD N35) who underwent one-stage anterior (CPT 53410) or posterior urethroplasty (CPT 53415), with or without (substitution urethroplasty) a tissue flap (CPT 15740) or buccal graft (CPT 15240 or 15241). We set urethroplasty as the index event and used descriptive statistics to report the incidence of secondary procedures (using CPT codes) within 10 years after the index event.
There were 6606 patients who underwent urethroplasty within the last 20 years, with 14.3% of patients undergoing a second procedure after index event. Upon subgroup analysis, reintervention rates were 14.5% for anterior urethroplasty vs. 12.4% of patients with an anterior substitution urethroplasty (RR 1.7, = 0.09) and 13.3% for posterior urethroplasty vs. 8.2% for patients with a posterior substitution urethroplasty (RR 1.6, < 0.01).
Most patients will not need any form of re-intervention following urethroplasty. These data align with previously described recurrence rates, which may help urologists counsel patients considering urethroplasty.
我们查询了一个全球数据库，以了解尿道成形术后的再次干预率，目的是评估这些数据是否与先前发表的数据一致。
使用TriNetX数据库以及通用程序术语（CPT）和国际疾病分类第10版（ICD）编码，我们确定了患有尿道狭窄疾病（ICD N35）的成年男性患者，他们接受了一期前路（CPT 53410）或后路尿道成形术（CPT 53415），有或没有（替代尿道成形术）组织瓣（CPT 15740）或颊黏膜移植（CPT 15240或15241）。我们将尿道成形术设定为索引事件，并使用描述性统计方法报告索引事件后10年内二次手术（使用CPT编码）的发生率。
在过去20年内有6606例患者接受了尿道成形术，其中14.3%的患者在索引事件后接受了二次手术。亚组分析显示，前路尿道成形术的再次干预率为14.5%，而前路替代尿道成形术患者的再次干预率为12.4%（相对危险度1.7，P = 0.09）；后路尿道成形术的再次干预率为13.3%，而后路替代尿道成形术患者的再次干预率为8.2%（相对危险度1.6，P < 0.01）。
大多数患者在尿道成形术后不需要任何形式的再次干预。这些数据与先前描述的复发率一致，这可能有助于泌尿外科医生为考虑接受尿道成形术的患者提供咨询。
