The urinary and sexual outcomes of buccal mucosal graft urethroplasty versus end-to-end anastomosis: a systematic review with meta-analysis.

IF 2.6 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Sexual Medicine Pub Date : 2024-09-21 eCollection Date: 2024-08-01 DOI:10.1093/sexmed/qfae064

Xingming Zhao, Qiang Guo, Xi Zhang, Qi Xing, Sheng Ren, Yuting Song, Chengyong Li, Chuan Hao, Jingqi Wang

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引用次数: 0

Abstract

Background: The urinary and sexual outcomes after urethroplasty may be a concern for patients, but there are still some controversies regarding the consequences of buccal mucosal graft urethroplasty (BMG) in terms of erectile dysfunction (ED).

Aim: This meta-analysis aimed to compare urinary and sexual outcomes of BMG and end-to-end urethroplasty (EE).

Methods: The PubMed, Web of Science, Cochrane, and Embase databases were searched until February 31, 2023. Data extraction and quality assessment were performed by 2 designated researchers. Dichotomous data were analyzed as odds ratios with 95% confidence intervals (CIs). Heterogeneity across studies was assessed by the I² quantification, and publication bias using Begg's and Egger's tests. Meta-analysis was performed using RevMan software.

Outcomes: Outcomes included stricture recurrence, ED, penile complications, and voiding symptoms.

Results: Eighteen studies, including 1648 participants, were included in our meta-analysis. The meta-analysis revealed that there was no significant difference in stricture recurrence (OR = 0.74; 95% CI, 0.48-1.13; P = .17) and voiding symptoms (OR = 1.12; 95% CI, 0.32-3.88; P = .86) between the BMG group and the EE group. BMG was associated with lower risk of penile complications (OR = 0.40; 95% CI, 0.24-0.69; P = .001) and ED (OR = 0.53, 95% CI, 0.32-0.90, P = .02).

Clinical implications: The study may help clinicians choose procedures that achieve better recovery of the urological and sexual function in the treatment of urethral stricture.

Strengths and limitations: This meta-analysis is the first to evaluate the urinary and sexual outcomes of BMG vs EE. A limitation is that most of the included studies were retrospective cohort studies.

Conclusion: BMG is as effective as EE in the treatment of bulbar urethral stricture, but BMG has fewer complications and ED than EE.

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颊粘膜移植尿道成形术与端对端吻合术的泌尿和性功能结果：系统回顾与荟萃分析。

背景：尿道成形术后的排尿和性功能结果可能是患者关心的问题，但关于颊粘膜移植尿道成形术（BMG）在勃起功能障碍（ED）方面的后果仍存在一些争议。目的：本荟萃分析旨在比较BMG和端对端尿道成形术（EE）的排尿和性功能结果：方法：对PubMed、Web of Science、Cochrane和Embase数据库进行检索，直至2023年2月31日。数据提取和质量评估由两名指定研究人员完成。二分法数据以带有 95% 置信区间 (CI) 的几率比进行分析。研究间的异质性通过 I2 量化进行评估，发表偏倚通过 Begg's 和 Egger's 检验进行评估。使用RevMan软件进行Meta分析：结果：结果包括狭窄复发、ED、阴茎并发症和排尿症状：我们的荟萃分析共纳入了 18 项研究，包括 1648 名参与者。荟萃分析表明，BMG 组和 EE 组在狭窄复发（OR = 0.74；95% CI，0.48-1.13；P = .17）和排尿症状（OR = 1.12；95% CI，0.32-3.88；P = .86）方面无显著差异。BMG与较低的阴茎并发症风险（OR = 0.40; 95% CI, 0.24-0.69; P = .001）和ED（OR = 0.53, 95% CI, 0.32-0.90, P = .02）相关：该研究可帮助临床医生在治疗尿道狭窄时选择能更好地恢复泌尿系统和性功能的手术：这项荟萃分析首次评估了BMG与EE的泌尿和性功能结果。局限性在于纳入的大多数研究都是回顾性队列研究：结论：在治疗球部尿道狭窄方面，BMG 与 EE 同样有效，但 BMG 比 EE 的并发症和 ED 更少。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sexual Medicine MEDICINE, GENERAL & INTERNAL-

CiteScore

5.40

自引率

0.00%

发文量

103

审稿时长

22 weeks

期刊介绍： Sexual Medicine is an official publication of the International Society for Sexual Medicine, and serves the field as the peer-reviewed, open access journal for rapid dissemination of multidisciplinary clinical and basic research in all areas of global sexual medicine, and particularly acts as a venue for topics of regional or sub-specialty interest. The journal is focused on issues in clinical medicine and epidemiology but also publishes basic science papers with particular relevance to specific populations. Sexual Medicine offers clinicians and researchers a rapid route to publication and the opportunity to publish in a broadly distributed and highly visible global forum. The journal publishes high quality articles from all over the world and actively seeks submissions from countries with expanding sexual medicine communities. Sexual Medicine relies on the same expert panel of editors and reviewers as The Journal of Sexual Medicine and Sexual Medicine Reviews.