Safety and efficacy of urethroplasty based on age groups

Actas Urol Esp (Engl Ed). 2021 Oct;45(8):557-563. doi: 10.1016/j.acuroe.2021.07.004. Epub 2021 Sep 12.
[Article in English, Spanish]

Abstract

Objective: To analyze the results and complications after urethroplasty based on patient age groups. As secondary objective, we analyzed the impact of operative complexity on each age group.

Material and methods: This is a retrospective cohort study that include male patients who underwent urethroplasty between January 2011 and December 2018. Data was obtained from the patients' electronic health records. Patients were grouped as follows: <60 years, 60-79 years and >80 years. Variables evaluated were history, comorbidities, previous surgeries and operative complexity. Restenosis-free survival and complications presented in each group were determined according to the Clavien-Dindo classification system. The SPSS® program was used for statistical analysis.

Results: A total of 783 patients were included, and the mean follow-up was 19 months. The estimated 2-year restenosis-free survival in the population under 60, 60-79 and over 80 years was 87, 87 and 93.9% (IC 95%), respectively. Univariate analysis showed that the age group was not a predictor of restenosis. Complex surgery is the only predictor of recurrence, increasing the risk by 60% (HR 1.64, 95% CI 1.05-2.56, p = 0.029). There was an overall complication rate of 30.8%, and 62% of these were Clavien ≤ II. We found no association between the frequency of complications and age.

Conclusions: Urethroplasty is safe and effective regardless of age group. There are no statistically significant differences in outcomes and complications shown by the age group comparison. There were no significant differences when analyzing the impact of complex surgeries among the different age groups. The data indicate that age alone should not be taken as an absolute exclusion criterion for patients needing urethral reconstruction.

Keywords: Adulto mayor; Complicaciones; Complications; Estenosis uretral; Older adult; Urethral stricture; Urethroplasty; Uretroplastia.

MeSH terms

  • Humans
  • Male
  • Plastic Surgery Procedures*
  • Retrospective Studies
  • Urethra / surgery
  • Urethral Stricture* / surgery
  • Urologic Surgical Procedures, Male