Clinical Factors That Predict Successful Posterior Urethral Anastomosis With a Gracilis Muscle Flap.
10.4111/kju.2013.54.10.710
- Author:
Jin Ho HWANG
1
;
Moon Hyung KANG
;
Young Tae LEE
;
Dong Soo PARK
;
Seung Ryeol LEE
Author Information
1. Department of Urology, CHA Bundang Medical Center, CHA University, Seongnam, Korea. seung102@cha.ac.kr
- Publication Type:Original Article
- Keywords:
Surgical anastomosis;
Surgical flap;
Urethral stricture
- MeSH:
Anastomosis, Surgical;
Constriction, Pathologic;
Follow-Up Studies;
Glia Maturation Factor;
Humans;
Logistic Models;
Muscles;
Pelvic Bones;
Recurrence;
Retrospective Studies;
Surgical Flaps;
Urethral Stricture
- From:Korean Journal of Urology
2013;54(10):710-714
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: We evaluated the preoperative clinical factors that affect the surgical outcome of posterior urethral anastomosis (PUA) with a gracilis muscle flap (GMF) to determine which factors predict benefit from the use of the GMF. MATERIALS AND METHODS: This was a retrospective analysis of 49 patients who underwent a delayed PUA with a GMF. A successful clinical outcome was defined as achieving a peak urinary flow rate greater than 15 mL/s at 3 and 12 months postoperatively without evidence of stricture recurrence on a retrograde urethrogram or cystourethroscopy at 3 months postoperatively. Multiple clinical factors were evaluated by use of univariate and multivariate analyses. RESULTS: The outcome of 21 of 49 patients (42.9%) was deemed successful. The mean age of the 49 patients was 37.2+/-13.5 years and the mean follow-up duration was 43.4+/-28.0 months. The length of the urethral defect was significantly shorter in patients with a successful outcome than in patients with an unsuccessful outcome (p=0.010). The outcome differed significantly depending on whether the patients had a previously successful urethroplasty (p=0.036) or whether they had suffered a pelvic bone injury (p=0.012). Multivariate logistic regression analyses revealed that a previous urethroplasty was the only preoperative clinical factor that significantly affected the surgical outcome in PUA with a GMF (odds ratio, 0.218; 95% confidence interval, 0.050 to 0.947; p=0.042). CONCLUSIONS: A history of previous urethroplasty is a preoperative clinical factor that significantly affects the surgical outcome in PUA with a GMF; the procedure is more likely to be successful in patients who have not previously undergone urethroplasty.
