UP-107 The incidence and associations of 90-day complications after urethroplasty
Thursday June 27, 2019 from
TBD
Presenter

Ryan Noble, Canada

Medical Student

Department of Surgery, Division of Urology

University of Alberta

Abstract

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.


Lectures by Ryan Noble


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