Document Detail


Outcomes of grafted bulbar urethroplasty in men with class II or III obesity.
MedLine Citation:
PMID:  22014595     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the outcomes of grafted bulbar urethroplasty in class II or III obese patients.
MATERIAL AND METHODS: Retrospective chart review was performed for men with World Health Organization class II/III obesity undergoing grafted urethroplasty for management of bulbar strictures from 2003-2010. Extracted data included age, body mass index (BMI), stricture etiology, stricture length/location, number/type of previous therapies, definitive therapy, follow-up, outcome, and complications. Outcomes were compared with a cohort of 20 age-matched nonobese men with bulbar strictures managed with grafted urethroplasty.
RESULTS: Fifteen class II/III obese men were included in the study. Obese patient age (43.8 years, range 27-60) and BMI (44.0 kg/m(2), range 35-57) were averaged. Each patient reported a mean of 3.8 previous dilations or urethrotomies (range 0-9). All men were treated with grafted bulbar urethroplasty (11 ventral, 4 dorsal) with oral mucosa (13 buccal, 2 lingual). After a mean follow-up of 29.4 months (range 7-62), the urethral patency rate was 66.7% (10/15). Complications included prolonged urethral leak in 5/15 (33%) and wound infection in 5/15 (33%) patients. Urethral patency rates and complications were significantly higher in class II/III obese patients when compared with the nonobese cohort.
CONCLUSION: Obese men demonstrated poorer outcomes after grafted bulbar urethroplasty when compared with published success rates in the general population as well as an aged-matched, nonobese cohort from our institution. Prior failed endoscopic procedures and other medical comorbidities may have also contributed to the observed results in this patient population.
Authors:
Jamie R Privratsky; Nima Almassi; Michael L Guralnick; Bradley J Anderson; R Corey O'Connor
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Publication Detail:
Type:  Journal Article     Date:  2011-10-19
Journal Detail:
Title:  Urology     Volume:  78     ISSN:  1527-9995     ISO Abbreviation:  Urology     Publication Date:  2011 Dec 
Date Detail:
Created Date:  2011-12-05     Completed Date:  2012-02-08     Revised Date:  2012-09-10    
Medline Journal Info:
Nlm Unique ID:  0366151     Medline TA:  Urology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1420-3     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Affiliation:
Department of Urology, Medical College of Wisconsin, Milwaukee, WI 53226, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Body Mass Index
Case-Control Studies
Humans
Male
Middle Aged
Mouth Mucosa / transplantation*
Obesity / complications*
Postoperative Complications / etiology*
Recurrence
Retrospective Studies
Treatment Outcome
Urethral Stricture / surgery*
Comments/Corrections
Comment In:
J Urol. 2012 Aug;188(2):471-2   [PMID:  22784735 ]
Urology. 2011 Dec;78(6):1423; author reply 1423   [PMID:  22137713 ]

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