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Inicio Actas Urológicas Españolas (English Edition) Safety and efficacy of urethroplasty based on age groups
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Vol. 45. Issue 8.
Pages 557-563 (October 2021)
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Vol. 45. Issue 8.
Pages 557-563 (October 2021)
Original article
Safety and efficacy of urethroplasty based on age groups
Seguridad y eficacia de la uretroplastia según grupos etarios
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3
G.A. Favre, T. Carminatti
Corresponding author
, S.A. Gil, I.P. Tobia González, C.R. Giudice
Sector de Cirugía Uretral y Genital Reconstructiva, Servicio de Urología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Tables (3)
Table 1. Demographic and clinical/surgical characteristics of the study groups.
Table 2. Univariate and multivariate analysis.
Table 3. Complications by age group.
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Abstract
Objective

To analyze the results and complications after urethroplasty based on patient age groups. As secondary objective, we analyzed the impact of operative complexity on each age group.

Material and methods

This is a retrospective cohort study that include male patients who underwent urethroplasty between January 2011 and December 2018. Data was obtained from the patients’ electronic health records. Patients were grouped as follows: <60 years, 60–79 years and >80 years. Variables evaluated were history, comorbidities, previous surgeries and operative complexity. Restenosis-free survival and complications presented in each group were determined according to the Clavien–Dindo classification system. The SPSS® program was used for statistical analysis.

Results

A total of 783 patients were included, and the mean follow-up was 19 months. The estimated 2-year restenosis-free survival in the population under 60, 60–79 and over 80 years was 87, 87 and 93.9% (IC 95%), respectively. Univariate analysis showed that the age group was not a predictor of restenosis. Complex surgery is the only predictor of recurrence, increasing the risk by 60% (HR 1.64, 95% CI 1.05–2.56, p = 0.029). There was an overall complication rate of 30.8%, and 62% of these were Clavien ≤ II. We found no association between the frequency of complications and age.

Conclusions

Urethroplasty is safe and effective regardless of age group. There are no statistically significant differences in outcomes and complications shown by the age group comparison. There were no significant differences when analyzing the impact of complex surgeries among the different age groups. The data indicate that age alone should not be taken as an absolute exclusion criterion for patients needing urethral reconstruction.

Keywords:
Urethroplasty
Older adult
Complications
Urethral stricture
Resumen
Objetivo

Analizar los resultados y las complicaciones posturetroplastia estratificando a los pacientes por edades. Como objetivo secundario, analizamos el impacto de la complejidad de la cirugía en cada grupo etario.

Material y método

Se trata de un estudio de cohortes, retrospectivo, donde se incluyó a todos los pacientes masculinos a quienes se les practicó uretroplastia entre enero de 2011 y diciembre de 2018. La información se obtuvo de la historia clínica electrónica. Los pacientes se agruparon en menores de 60 años, de 60 a 79 años y mayores de 80 años. Se evaluaron diferentes variables como antecedentes, comorbilidades, cirugías previas, complejidad de la cirugía. Se determinó la supervivencia libre de reestenosis y las complicaciones presentadas en cada grupo, según la clasificación de Clavien Dindo. Se utilizó el programa SPSS® para el análisis estadístico.

Resultados

Se incluyeron un total de 783 pacientes. El seguimiento promedio fue de 19 meses. La sobrevida estimada a dos años libre de reestenosis en la población menor a 60, de 60 a 79 y mayor de 80 años fue de 87, 87 y 93,9% (IC 95%), respectivamente. En el análisis univariado, el grupo etario no fue una variable predictora de reestenosis. La realización de cirugía compleja es el único factor predictor de recidiva, aumentando el riesgo en un 60% (HR 1,64 IC 95% 1,05–2,56 p = 0,029). Se presentó una tasa general de complicaciones del 30,8%, siendo el 62% Clavien menor a dos. No encontramos asociación entre la frecuencia de las mismas y la edad.

Conclusiones

La uretroplastia es segura y eficaz independientemente del grupo etario. No hay diferencias estadísticamente significativas en cuanto a los resultados y complicaciones comparando los diferentes grupos etarios. Tampoco encontramos diferencias significativas cuando analizamos el impacto de las cirugías complejas entre los diferentes grupos etarios. Los datos indican que la edad, como único factor, no debe ser excluyente para los pacientes que necesitan una reconstrucción de la uretra.

Palabras clave:
Uretroplastia
Adulto mayor
Complicaciones
Estenosis uretral

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