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Sclerosis as a predictive factor for failure after bulbar urethroplasty: a prospective single-centre study
Teresa Olsen Ekerhult1, Klas Lindqvist1, Lars Grenabo1
1a Department of Urology , Institute of Clinical Sciences at Sahlgrenska Academy, Sahlgrenska University Hospital , Gothenburg , Sweden.
Scandinavian Journal of Urology
|November 2, 2018
Summary
Sclerosis in urethral stricture histology predicts surgical failure after bulbar urethroplasty. This finding highlights the importance of histopathological analysis in predicting outcomes for urethroplasty patients.
Area of Science:
- Urology
- Pathology
- Surgical Outcomes
Background:
- Bulbar urethroplasty is a common surgical treatment for urethral strictures.
- Histopathological features of resected stricture tissue are not well-established predictors of surgical success.
Purpose of the Study:
- To determine if histological sclerosis in resected urethral stricture specimens predicts surgical failure following bulbar urethroplasty.
Main Methods:
- Resected stricture specimens from 45 patients undergoing urethroplasty were analyzed for fibrosis, inflammation, and sclerosis.
- Histological findings were compared between patients with successful outcomes and those with surgical failure.
- Uropathologist was blinded to clinical outcomes during analysis.
Main Results:
- Sclerosis was identified in 11 of 13 patients with grade III fibrosis.
- Sclerosis was significantly associated with a higher risk of surgical failure (restricture).
- This association remained significant after adjusting for age, inflammation, and stricture length.
Conclusions:
- Histological evidence of sclerosis in resected urethral strictures is a significant predictor of postoperative restricture.
- Pathological assessment of stricture specimens can aid in predicting urethroplasty outcomes.
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