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Routine Imaging After Bulbar Urethral Reconstruction Does Not Impact Surgical Outcomes and May Not Be Necessary
Carlos I Calvo1, Keith F Rourke2
1Division of Urology, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada; Departamento de Urología, Pontificia Universidad Católica de Chile, Santiago, Chile.
Urology
|February 28, 2024
Summary
Omitting routine post-operative voiding cystourethrogram (VCUG) after bulbar urethroplasty does not impact complication or recurrence rates. This study suggests avoiding unnecessary imaging in clinical practice.
Area of Science:
- Urology
- Surgical Outcomes
- Medical Imaging
Background:
- Routine post-operative contrast imaging, such as voiding cystourethrogram (VCUG), is commonly performed after bulbar urethroplasty.
- The clinical necessity and impact of routine imaging prior to catheter removal remain unclear.
Purpose of the Study:
- To evaluate if omitting routine post-operative imaging after bulbar urethroplasty affects clinical outcomes.
- To determine the impact on 90-day complications and long-term stricture recurrence.
Main Methods:
- A matched case-control analysis compared patients who underwent routine VCUG with those who did not after bulbar urethroplasty.
- Patients were matched by age, stricture etiology, length, and surgical technique.
- Outcomes assessed included 90-day complications (Clavien ≥2) and stricture recurrence, with follow-up including clinical assessment and cystoscopy.
Main Results:
- No significant difference in 90-day complications (12% vs. 7.0%, P=0.34) between the VCUG and no-imaging groups.
- Stricture recurrence rates were also similar between groups (P=0.44).
- The incidence of extravasation in the VCUG group was 2%.
Conclusions:
- Routine post-operative VCUG following bulbar urethroplasty does not appear to influence complication rates or risk of stricture recurrence.
- Surgeons may consider omitting routine imaging to avoid unnecessary procedures in clinical practice.
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