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World Journal of Urology

, Volume 37, Issue 4, pp 655–660 | Cite as

Single-surgeon series of delayed anastomotic urethroplasty for pelvic fracture urethral injury: an analysis of surgical and patient-reported outcomes of a 10-year experience in a Japanese referral center

  • Akio HoriguchiEmail author
  • Masayuki Shinchi
  • Kenichiro Ojima
  • Ayako Masunaga
  • Keiichi Ito
  • Tomohiko Asano
  • Eiji Takahashi
  • Fumihiro Kimura
  • Ryuichi Azuma
Topic Paper

Abstract

Purpose

To report our experience with delayed anastomotic urethroplasty for pelvic fracture urethral injury (PFUI) during the last 10 years and evaluate both surgical and patient-reported outcomes.

Methods

Retrospective analysis of 115 patients undergoing delayed anastomotic urethroplasty for PFUI between 2008 and 2017 by a single surgeon (AH) was performed. Success was defined as a urethral lumen large enough for passage of a 17-Fr flexible cystoscope. We asked patients to complete questionnaires before (baseline) and 1 year after urethroplasty and compared by paired t and Wilcoxon signed-rank tests the answers to a question about LUTS-specific QOL and the health-related QOL indicated by EQ-5D index and visual analogue scores (EQVAS). Overall patient satisfaction 1 year after urethroplasty was also evaluated.

Results

Urethroplasty was successful in 108 patients (93.9%), and failed urethroplasty was significantly associated with greater intraoperative blood loss (p = 0.009) and smaller surgical experience (p = 0.018). Sixty-six patients (57.4%) completed questionnaires 1 year after urethroplasty, and 65 of those 66 (98.5%) were “satisfied” (36.4%) or “very satisfied” (62.1%) with the outcome of their urethroplasty. The LUTS-specific QOL scores (p < 0.0001), EQ-5D index scores (p < 0.0001), and EQVAS scores (p < 0.0001) all improved significantly after urethroplasty.

Conclusions

Delayed anastomotic urethroplasty has a high success rate and significant beneficial effects on both LUTS-specific and health-related QOL, resulting in high patient satisfaction. Careful manipulation in a bloodless operative field by experienced surgeons could be the key to successful urethroplasty.

Keywords

Pelvic fracture Urethral injury Urethroplasty Patient-reported outcome 

Notes

Acknowledgements

This study was supported by a grant for scientific research from the Ministry of Education, Science, Sports and Culture (16H05467). We have no financial interests to disclose.

Author contributions

AH: data collection, project development, data analysis, and manuscript writing. MS: data collection/analysis. KO: data collection. AM: data collection. KI: data collection. TA: data collection. ET: data collection. FK: data collection. RA: data collection, project development, and manuscript editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Research involving human participants and/or animals

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

For this type of study, formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of UrologyNational Defense Medical CollegeTokorozawaJapan
  2. 2.Department of UrologyNishisaitama-chuo National HospitalSaitamaJapan
  3. 3.Department of Plastic SurgeryNational Defense Medical CollegeSaitamaJapan

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