Department of Surgery, Division of Urology
University of Alberta
The incidence and associations of 90-day complications after urethroplasty
Ryan Noble1, Keith F. Rourke1, Nathan Hoy1.
1Department of Surgery, University of Alberta, Edmonton, AB, Canada
Our objective is to determine the incidence of 90-day complications after urethroplasty as well as associated predisposing factors.
A retrospective review was performed on patients undergoing urethroplasty for urethral stricture at the University of Alberta from 08/2003-06/2020. Abstracted variables included the incidence/number/type of complications, Clavien-Dindo grade (CDG), and patient comorbidities based on the corresponding component of the Charlson comorbidity index (CCI) among others. The primary outcome was incidence of 90-day complications. A CDG grade ≥2 was defined as significant. Descriptive statistics and regression were used to examine the factors associated with 90-day complications.
Mean age of the 1611 patients in our analysis was 47.6 years (18-94), mean stricture length was 4.5 cm, 82.0% failed prior endoscopic treatment and 17.6% had prior urethroplasty. 90-day complications (CDG ≥2) occurred in 7.9% of patients. These were wound-related (3.5%), urinary tract infection (3.4%), cardiovascular (0.4%), catheter-related (0.2%), hematuria (0.1%), retention (0.1%) or other (0.2%). On univariate analysis stricture location (p=0.04), length (p=0.009), CCI (p<0.0001), prior urethroplasty (p=0.01) and pre-operative bacteriuria (p=0.002) were associated with 90-day complications while age (p=0.27), etiology (p=0.15), smoking (p=0.17), BMI>35 (p=0.27), failed endoscopic treatment (p=0.84), indwelling suprapubic catheter (p=0.68) and type of urethroplasty (p=0.09) were not. On multivariate analysis, increasing CCI (Odds Ratio 1.32, 95%CI 1.10-1.59; p=0.004), prior urethroplasty (O.R.1.85, 95%CI 1.08-3.17; p=0.02 and pre-operative bacteriuria (O.R.1.69, 95%CI 1.14-2.52; p=0.01) remained associated with rates of 90-day complications.
Patients with increased comorbidities, prior urethroplasty and pre-operative bacteriuria are at increased risk for complications after urethroplasty and should be counselled accordingly in a shared decision-making model of care.
||Unmoderated Posters||The incidence and associations of 90-day complications after urethroplasty||TBD|