Presentation Authors: Madeline Cancian, Atlanta, GA, Eric Jung*, Kennon Miller, Providence, RI
Introduction: Retrograde urethrograms (RUG) are utilized 2-3 weeks after urethroplasty to help guide management of indwelling urethral catheters. To our knowledge, there is no published data to guide RUG interpretation. Our goal was to classify post-operative RUG findings and determine if they predict recurrence of urethral strictures.
Methods: All available post-urethroplasty RUGs between 4/1/2005 to 6/1/2016 were reviewed by one author (KSM). Results were classified into four categories: normal, contour irregularity (CI), contained extravasation (CE) and frank extravasation (FE) (Figure 1). Stricture recurrence was defined as symptoms with inability to pass a 16 Fr flexible cystoscope or evidence of stricture on subsequent RUG. Statistical analysis was completed using SAS.
Results: 172 patients were included. Median follow up was 24 months [range 1-130 months]. Compared to normal, there was an increased odds ratio of developing re stricture for contour irregularity of 3.4, contained extravasation of 1.3 and frank extravasation of 5.2 [cox proportional hazard regression, p = 0.048]. Overall, length of stricture had no association with RUG findings (p=0.30), however, each 1 cm increase in stricture length conferred a 16% increased odds of developing a recurrence [p=0.01]. The groups with the highest re-stricture rates, contour irregularity and frank extravasation, had a higher mean stricture length than the other two groups (6.1 cm & 5.4 cm vs 2.4 cm & 2.6 cm) (Table 1). There was no association between BMI, age, or smoking status with subsequent urethral stricture recurrence.
Conclusions: Patients with an abnormal RUG had a higher odds ratio of stricture recurrence. We suspect the increased odds of developing a re-stricture in the contour irregularity group was related to the longer mean stricture length. Due to the similar stricture rates in the contained extravasation and normal RUG groups, we would not recommend prolonged catheterization except it patients with frank extravasation.