Patient-reported outcomes after one-stage neourethral reconstruction in transmen with phalloplasty-associated strictures and fistulas.

IF 2.8 2区 医学 Q2 UROLOGY & NEPHROLOGY
Victor M Schuettfort, Rebecca R Graf, Malte W Vetterlein, Tim A Ludwig, Philipp Gild, Phillip Marks, Armin Soave, Roland Dahlem, Margit Fisch, Silke Riechardt
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引用次数: 0

Abstract

Introduction: Urethral strictures and fistulas arising after gender-affirming surgery in transmen require meticulous management strategies. This study evaluates the safety and efficacy of urethral reconstruction and patient satisfaction post-surgery.

Methods: A retrospective analysis examined peri- and postoperative data from transmen undergoing urethral reconstruction for urethral fistula and/or strictures at the distal urethral anastomosis between December 2017 and April 2023. Follow-up involved clinical examinations, uroflowmetry, and voiding cystourethrography. Patient satisfaction and quality of life were assessed using USS PROM and ICIQ-S questionnaires.

Results: Among 25 patients, 88% (n = 23) had urethral fistulas, and 48% (n = 12) had urethral strictures. 41% of fistula patients also had strictures, while 75% of stricture patients had concurrent fistulas. Previous surgeries for fistula or stricture repair were noted in 26% of cases. Techniques for stricture included modified flap (50%), buccal oral mucosal grafting (33%), and primary anastomosis (17%). Post-operative urethrogram revealed urethral strictures in 15% (n = 3) and urinary extravasation in an equal number. Postoperative uroflow parameters showed improvement (Qmax 18 ml/s, Qave 7.9 ml, time 37 s, volume 332 ml). Perioperative complications were low (n = 6, 24%), all grade one (Clavien-Dindo). Follow-up revealed that 33% required another surgical intervention. The mean six-item LUTS score was 6.7 (SD 3.9). Mean ICIQ-S overall satisfaction score was 8.6 (SD 1.6) and outcome score was 20 (SD 2.8).

Discussion: Our study found a significant recurrence rate of urethral strictures and fistulas post-surgery. Despite this, patient satisfaction remains high and complications are generally low-grade, highlighting the importance of expert surgical intervention.

对患有阴茎整形术相关狭窄和瘘管的变性人进行一段式新尿道重建术后的患者报告结果。
导言:变性人在接受性别确认手术后出现尿道狭窄和瘘管,需要采取细致的管理策略。本研究评估了尿道重建的安全性和有效性以及术后患者的满意度:回顾性分析研究了2017年12月至2023年4月期间因尿道瘘和/或尿道远端吻合处狭窄而接受尿道重建术的跨性别男性的围手术期和术后数据。随访包括临床检查、尿流率测定和排尿膀胱造影。使用 USS PROM 和 ICIQ-S 问卷对患者的满意度和生活质量进行评估:在 25 名患者中,88%(n = 23)患有尿道瘘,48%(n = 12)患有尿道狭窄。41%的瘘管患者同时患有尿道狭窄,而75%的尿道狭窄患者同时患有瘘管。26%的病例曾接受过瘘管或狭窄修复手术。治疗狭窄的技术包括改良皮瓣术(50%)、口腔颊粘膜移植术(33%)和原位吻合术(17%)。术后尿道造影显示,尿道狭窄的比例为 15%(3 例),尿液外渗的比例相同。术后尿流参数有所改善(Qmax 18 毫升/秒,Qave 7.9 毫升,时间 37 秒,容量 332 毫升)。围手术期并发症较少(6 例,24%),均为一级并发症(Clavien-Dindo)。随访显示,33%的患者需要再次手术治疗。六项 LUTS 评分的平均值为 6.7(标清 3.9)。ICIQ-S总体满意度平均得分为8.6(标清1.6),结果得分为20(标清2.8):讨论:我们的研究发现,尿道狭窄和瘘管术后复发率很高。讨论:我们的研究发现,尿道狭窄和瘘管术后复发率很高,尽管如此,患者的满意度仍然很高,而且并发症一般较少,这凸显了专家手术干预的重要性。
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
World Journal of Urology
World Journal of Urology 医学-泌尿学与肾脏学
CiteScore
6.80
自引率
8.80%
发文量
317
审稿时长
4-8 weeks
期刊介绍: The WORLD JOURNAL OF UROLOGY conveys regularly the essential results of urological research and their practical and clinical relevance to a broad audience of urologists in research and clinical practice. In order to guarantee a balanced program, articles are published to reflect the developments in all fields of urology on an internationally advanced level. Each issue treats a main topic in review articles of invited international experts. Free papers are unrelated articles to the main topic.
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