Assessing in-hospital morbidity after urethroplasty using the European Association of Urology Quality Criteria for standardized reporting.
Adult
Aged
Europe
Humans
Kalanchoe
Logistic Models
Male
Middle Aged
Perineum
/ surgery
Postoperative Complications
/ epidemiology
Postoperative Hemorrhage
/ epidemiology
Proportional Hazards Models
Quality of Health Care
Plastic Surgery Procedures
/ methods
Retrospective Studies
Surgical Wound Infection
/ epidemiology
Urethral Stricture
/ surgery
Urologic Surgical Procedures, Male
/ methods
Clavien
Complications
Dindo
EAU guidelines
Methodology
Urethroplasty
Journal
World journal of urology
ISSN: 1433-8726
Titre abrégé: World J Urol
Pays: Germany
ID NLM: 8307716
Informations de publication
Date de publication:
Oct 2021
Oct 2021
Historique:
received:
09
01
2021
accepted:
30
03
2021
pubmed:
16
4
2021
medline:
19
2
2022
entrez:
15
4
2021
Statut:
ppublish
Résumé
To conduct a rigorous assessment of in-hospital morbidity after urethroplasty according with the European Association of Urology (EAU) guidelines for complication reporting. We retrospectively (2015-2019) identified 469 consecutive patients receiving urethroplasty (e.g. bulbar urethroplasty with grafts, penile urethroplasty with/without grafts/flaps, Johanson, de novo or revision perineostomy, end-to-end anastomosis, meatoplasty and/or meatotomy) at our tertiary care institution. Complications were graded with Clavien-Dindo score and Comprehensive Complication Index (CCI). Complications were classified in: bleeding no gastrointestinal, cardiac, gastrointestinal, genitourinary, infectious, neurological, oral, wound, miscellaneous, and pulmonary. Logistic regression tested for predictors of in-hospital complications and prolonged hospitalization (> 75th percentile). Kaplan-Meier and Cox regression investigated the effect of complications on failure after urethroplasty. Overall, 161 (34.3%) patients experienced at least one complication. Of those, 47 (10%) experienced two or more complications and 59 (12.6%) experienced at least one Clavien-Dindo ≥ II complication. Only two patients had Clavien-Dindo III complications. Infectious was the most frequent complication, and de novo or revision perineostomy was associated with the highest rate of complications. The occurrence of any complications, as well as complication with Clavien-Dindo ≥ II were associated with prolonged hospitalizations, but not with higher rates of post-urethroplasty failure. Complications after urethroplasty were common events, but rarely with severe sequelae. Infectious were the most common complications and perineostomy was the type of urethroplasty with the highest rate of complications. The application of the EAU recommendations allowed the identifications of a higher number of complications after urethroplasty if compared with previous reports based on unsupervised chart review.
Identifiants
pubmed: 33855598
doi: 10.1007/s00345-021-03692-8
pii: 10.1007/s00345-021-03692-8
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
3921-3930Informations de copyright
© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
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