Tabei Tadashi, Horiguchi Akio, Shinchi Masayuki, Hirano Yusuke, Ojima Kenichiro, Ito Keiichi, Azuma Ryuichi
Department of Urology, National Defense Medical College, Saitama, Japan; Department of Urology, Fujisawa Shounandai Hospital, Kanagawa, Japan.
Department of Urology, National Defense Medical College, Saitama, Japan.
Urology. 2025 Jan;195:168-173. doi: 10.1016/j.urology.2024.09.022. Epub 2024 Sep 19.
To validate the value of the LSE classification and scoring system in predicting surgical outcomes for male anterior urethral stricture cases.
A retrospective review was conducted on 566 patients who underwent urethroplasty between August 2004 and March 2022. After excluding pelvic fracture urethral injury and non-stricture diseases and incomplete data, 358 patients were classified according to the LSE classification system, and both U score and LSE score were calculated. We investigated the relationship between LSE score and U score in predicting recurrence. Recurrence was defined as any instance requiring re-intervention. To identify factors contributing to recurrence, logistic regression analysis was performed on the LSE score and variables not included in the scoring system.
The breakdown of S, and E components showed external trauma as the most common cause of strictures, with proximal bulbar urethra being the most common segment. Significant associations were observed between stricture etiology and segment, as well as between surgical technique and segment. A strong correlation (r = 0.73) was found between U score and LSE score, with no significant difference in predicting recurrence between the 2 scores. Surgical complexity differed significantly between LSE score groups, but surgical duration did not. Patients with LSE <7 showed a better recurrence rate in Kaplan-Meier analysis. Multivariate logistic analysis identified LSE ≥7 as an independent risk factor for recurrence.
The LSE classification system and scoring system demonstrate validity in characterizing anterior urethral strictures and predicting surgical outcomes.
验证LSE分类及评分系统在预测男性前尿道狭窄病例手术结局方面的价值。
对2004年8月至2022年3月期间接受尿道成形术的566例患者进行回顾性研究。排除骨盆骨折所致尿道损伤、非狭窄性疾病及数据不完整的病例后，根据LSE分类系统对358例患者进行分类，并计算U评分和LSE评分。我们研究了LSE评分与U评分在预测复发方面的关系。复发定义为任何需要再次干预的情况。为确定导致复发的因素，对LSE评分及评分系统未纳入的变量进行逻辑回归分析。
S和E成分的分类显示，外部创伤是狭窄最常见的原因，近端球部尿道是最常见的部位。在狭窄病因与部位之间以及手术技术与部位之间观察到显著关联。U评分与LSE评分之间存在强相关性（r = 0.73），这两个评分在预测复发方面无显著差异。LSE评分组之间手术复杂性差异显著，但手术时长无差异。在Kaplan-Meier分析中，LSE<7的患者复发率较低。多因素逻辑分析确定LSE≥7是复发的独立危险因素。
LSE分类系统和评分系统在描述前尿道狭窄及预测手术结局方面具有有效性。
