The effect of proliferative hypertrophic scars on determining treatment options for preventing recurrence of vesicourethral anastomotic stenosis after radical prostatectomy: a single-center cross-sectional study
São Paulo med. j
;
139(3): 241-250, May-June 2021. tab, graf
Article
in English
| LILACS
| ID: biblio-1252244
ABSTRACT
ABSTRACT BACKGROUND:
Vesicourethral anastomotic stenosis (VUAS) following retropubic radical prostatectomy (RRP) significantly worsens quality of life.OBJECTIVES:
To investigate the relationship between proliferative hypertrophic scar formation and VUAS, and predict more appropriate surgical intervention for preventing recurrent VUAS. DESIGN ANDSETTING:
Retrospective cross-sectional single-center study on data covering January 2009 to December 2019.METHODS:
Among 573 male patients who underwent RRP due to prostate cancer, 80 with VUAS were included. They were divided into two groups according to VUAS treatmentmethod:
dilatation using Amplatz renal dilators (39 patients); or endoscopic bladder neck incision/resection (41 patients). The Vancouver scar scale (VSS) was used to evaluate the characteristics of scars that occurred for any reason before development of VUAS.RESULTS:
Over a median follow-up of 72 months (range 12-105) after RRP, 17 patients (21.3%) had recurrence of VUAS. Although the treatment success rates were similar (79.5% versus 78.0%; P = 0.875), receiver operating characteristic (ROC) curve analysis indicated that dilatation using Amplatz dilators rather than endoscopic bladder neck incision/resection in patients with VSS scores 4, 5 and 6 may significantly reduce VUAS recurrence. A strong positive relationship was observed between VSS and total number of VUAS occurrences (r 0.689; P < 0.001). VSS score (odds ratio, OR 5.380; P < 0.001) and time until occurrence of VUAS (OR 1.628; P = 0.008) were the most significant predictors for VUAS recurrence.CONCLUSIONS:
VSS score can be used as a prediction tool for choosing more appropriate surgical intervention, for preventing recurrent VUAS.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Urethral Stricture
/
Cicatrix, Hypertrophic
Type of study:
Observational study
/
Prevalence study
/
Prognostic study
/
Risk factors
Limits:
Humans
/
Male
Language:
English
Journal:
São Paulo med. j
Journal subject:
Cirurgia Geral
/
Cincia
/
Ginecologia
/
Medicine
/
Medicina Interna
/
Obstetr¡cia
/
Pediatria
/
Sa£de Mental
/
Sa£de P£blica
Year:
2021
Type:
Article
Affiliation country:
Turkey
Institution/Affiliation country:
Health Science University Dr. Abdurrahman Yurtaslan/TR
/
Karabük University Training and Research Hospital/TR
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