Yoshikawa Gustavo Bono, Gomar Gabriella Giandotti, Gadens Giovanna Ceccatto, Saes Beatriz França Zanetti, Galiciolli Maria Eduarda Andrade, Pereira Meire Ellen, Garlet Quelen Iane, Oliveira Cláudia Sirlene
Instituto de Pesquisa Pelé Pequeno Príncipe - Curitiba (PR) - Brazil.
Faculdades Pequeno Príncipe - Curitiba (PR) - Brazil.
Acta Cir Bras. 2025 Mar 31;40:e403525. doi: 10.1590/acb403525. eCollection 2025.
To determine risk factors for re-stricture after buccal mucosal graft urethroplasty (BMGU) through a systematic review and meta-analysis.
Following PRISMA guidelines, we collected data from PubMed, Scientific Electronic Library Online (SciELO), and Web of Science databases. The eligibility criteria included studies with male patients over 18 years old with urethral stricture recurrence after BMGU.
We retrieved 646 papers from three electronic databases. Records that did not meet the eligibility criteria and duplicates were excluded, resulting in 14 papers (3,240 patients) that underwent qualitative analysis, from which nine papers were suitable for meta-analysis. The meta-analysis identified diabetes mellitus (relative risk - RR: 1.58 [95% confidence interval - 95%CI 1.02-2.46];p = 0.04), penile/peno-bulbar site (RR: 1.57 [95%CI 1.04-2.37]; p = 0.03), and stricture size higher than 7 cm (RR: 4.13 [95%CI 2.42-7.04]; p 0.00001) as a predictive factor of re-stricture.
These findings may improve understanding the risk factors for this type of urethroplasty and help surgical decisions. For a more effective analysis, larger and better-distributed study groups and cohorts are needed in the future to clarify whether the combination of a previous disease and the urethroplasty etiology may impact a recurrence-free outcome after stricture correction.
通过系统评价和荟萃分析确定颊黏膜移植尿道成形术（BMGU）后再狭窄的危险因素。
按照PRISMA指南，我们从PubMed、科学电子图书馆在线数据库（SciELO）和科学网数据库收集数据。纳入标准包括年龄超过18岁的男性患者在BMGU后发生尿道狭窄复发的研究。
我们从三个电子数据库中检索到646篇论文。排除不符合纳入标准的记录和重复记录后，有14篇论文（3240例患者）进行了定性分析，其中9篇论文适合进行荟萃分析。荟萃分析确定糖尿病（相对危险度-RR：1.58[95%置信区间-95%CI 1.02-2.46]；p=0.04）、阴茎/阴茎球部位置（RR：1.57[95%CI 1.04-2.37]；p=0.03）以及狭窄长度大于7cm（RR：4.13[95%CI 2.42-7.04]；p<0.00001）为再狭窄的预测因素。
这些发现可能有助于加深对这类尿道成形术危险因素的理解，并有助于手术决策。为了进行更有效的分析，未来需要更大且分布更合理的研究组和队列，以明确既往疾病与尿道成形术病因的组合是否会影响狭窄矫正后的无复发结局。
