Is the Bulbar Urethral Stricture a Single and Uniform Disease?
<b>Objectives:</b> Proximal and distal bulbar urethral strictures (BUS) have different disease characteristics and require different treatment strategies despite being regarded as a single condition. To clarify the differences, we analyzed our database by distinguishing the two types of...
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MDPI AG
2024-04-01
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| Series: | Société Internationale d’Urologie Journal |
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| author | Tadashi Tabei Akio Horiguchi Masayuki Shinchi Yusuke Hirano Kenichiro Ojima Keiichi Ito Ryuichi Azuma |
| author_facet | Tadashi Tabei Akio Horiguchi Masayuki Shinchi Yusuke Hirano Kenichiro Ojima Keiichi Ito Ryuichi Azuma |
| author_sort | Tadashi Tabei |
| collection | DOAJ |
| description | <b>Objectives:</b> Proximal and distal bulbar urethral strictures (BUS) have different disease characteristics and require different treatment strategies despite being regarded as a single condition. To clarify the differences, we analyzed our database by distinguishing the two types of BUS. <b>Methods:</b> We retrospectively reviewed the data of 196 patients with BUS who underwent urethroplasty at the National Defense Medical College (Japan) between August 2004 and March 2022. We divided patients into proximal (group 1) or distal (group 2) groups based on the stricture segment and compared patient background and surgical techniques for each group. We assessed whether the stricture segment was an independent predictive factor for substitution urethroplasty selection using multivariate logistic regression analysis. The recurrence rates were calculated and compared using the Kaplan–Meier method and log-rank test, respectively. <b>Results:</b> Patients in group 1 had a less frequent non-obliterated lumen (73% vs. 94%, <i>p</i> = 0.020) and significantly shorter strictures (10 mm vs. 23 mm, <i>p</i> < 0.001) more frequently caused by external traumas (47% vs. 26%, <i>p</i> = 0.010) than those in group 2. Logistic regression analysis revealed that the stricture segment (distal) (<i>p</i> < 0.001), stricture length (≥20 mm) (<i>p</i> < 0.001), ≥2 prior transurethral procedures (<i>p</i> = 0.030), and a non-obliterated lumen (<i>p</i> = 0.020) were independent predictive factors for substitution urethroplasty. However, the recurrence rate (<i>p</i> = 0.18) did not significantly differ between the two groups. <b>Conclusions:</b> Proximal and distal BUS have substantially different anatomical characteristics and etiologies and require different reconstructive techniques. |
| format | Article |
| id | doaj-art-afcf47e729f0443d8c531c8295e6ec95 |
| institution | DOAJ |
| issn | 2563-6499 |
| language | English |
| publishDate | 2024-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Société Internationale d’Urologie Journal |
| spelling | doaj-art-afcf47e729f0443d8c531c8295e6ec952025-08-20T02:54:37ZengMDPI AGSociété Internationale d’Urologie Journal2563-64992024-04-0152859210.3390/siuj5020014Is the Bulbar Urethral Stricture a Single and Uniform Disease?Tadashi Tabei0Akio Horiguchi1Masayuki Shinchi2Yusuke Hirano3Kenichiro Ojima4Keiichi Ito5Ryuichi Azuma6Department of Urology, Fujisawa Shounandai Hospital, Fujisawa 252-0802, JapanDepartment of Urology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Urology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Urology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Urology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Urology, National Defense Medical College, Tokorozawa 359-8513, JapanDepartment of Plastic Surgery, National Defense Medical College, Tokorozawa 359-8513, Japan<b>Objectives:</b> Proximal and distal bulbar urethral strictures (BUS) have different disease characteristics and require different treatment strategies despite being regarded as a single condition. To clarify the differences, we analyzed our database by distinguishing the two types of BUS. <b>Methods:</b> We retrospectively reviewed the data of 196 patients with BUS who underwent urethroplasty at the National Defense Medical College (Japan) between August 2004 and March 2022. We divided patients into proximal (group 1) or distal (group 2) groups based on the stricture segment and compared patient background and surgical techniques for each group. We assessed whether the stricture segment was an independent predictive factor for substitution urethroplasty selection using multivariate logistic regression analysis. The recurrence rates were calculated and compared using the Kaplan–Meier method and log-rank test, respectively. <b>Results:</b> Patients in group 1 had a less frequent non-obliterated lumen (73% vs. 94%, <i>p</i> = 0.020) and significantly shorter strictures (10 mm vs. 23 mm, <i>p</i> < 0.001) more frequently caused by external traumas (47% vs. 26%, <i>p</i> = 0.010) than those in group 2. Logistic regression analysis revealed that the stricture segment (distal) (<i>p</i> < 0.001), stricture length (≥20 mm) (<i>p</i> < 0.001), ≥2 prior transurethral procedures (<i>p</i> = 0.030), and a non-obliterated lumen (<i>p</i> = 0.020) were independent predictive factors for substitution urethroplasty. However, the recurrence rate (<i>p</i> = 0.18) did not significantly differ between the two groups. <b>Conclusions:</b> Proximal and distal BUS have substantially different anatomical characteristics and etiologies and require different reconstructive techniques.https://www.mdpi.com/2563-6499/5/2/14surgerydiagnosisetiologyurethral stricture |
| spellingShingle | Tadashi Tabei Akio Horiguchi Masayuki Shinchi Yusuke Hirano Kenichiro Ojima Keiichi Ito Ryuichi Azuma Is the Bulbar Urethral Stricture a Single and Uniform Disease? Société Internationale d’Urologie Journal surgery diagnosis etiology urethral stricture |
| title | Is the Bulbar Urethral Stricture a Single and Uniform Disease? |
| title_full | Is the Bulbar Urethral Stricture a Single and Uniform Disease? |
| title_fullStr | Is the Bulbar Urethral Stricture a Single and Uniform Disease? |
| title_full_unstemmed | Is the Bulbar Urethral Stricture a Single and Uniform Disease? |
| title_short | Is the Bulbar Urethral Stricture a Single and Uniform Disease? |
| title_sort | is the bulbar urethral stricture a single and uniform disease |
| topic | surgery diagnosis etiology urethral stricture |
| url | https://www.mdpi.com/2563-6499/5/2/14 |
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