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Excision and primary anastomosis for isolated, short, anastomotic strictures in transmen

Wesley Verla (UGent) , Piet Hoebeke (UGent) , Anne-Françoise Spinoit (UGent) , Marjan Waterloos (UGent) , Stan Monstrey (UGent) and Nicolaas Lumen (UGent)
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Abstract
Background: Since the recommendation to perform excision and primary anastomosis (EPA) for isolated, short, anastomotic strictures in transmen, there have been no further reports about its results. This study aims to provide an updated and extended report about the results of EPA for the aforementioned indication. Methods: Since 2002, data of all transmen in whom an EPA urethroplasty has been performed at Ghent University Hospital were collected in a database. Exclusion criteria for this analysis were age <18 years old, nonanastomotic strictures, and stricture length >3.0 cm. Postoperative complications were analyzed with descriptive statistics. Failure-free survival (FFS) was analyzed with Kaplan-Meier statistics. Need for further urethral manipulation was used as definition for failure. Potential predictors for failure were entered in a univariate Cox regression analysis. Results: In total, 44 patients were included with a median (interquartile range) follow-up of 40 months (7-125 months). Complications after EPA urethroplasty were present in 12 (27%) of the patients and mainly involved low-grade complications (11/44, 25%). After 1, 2, and 5 years, the estimated FFS rate (SD) was 61% (7.8), 61% (7.8), and 47% (9.1). Stricture length (hazard ratio [HR], 2.11; P = 0.03), prior urethroplasty (HR, 3.53; P = 0.008), and extravasation at first voiding cystourethrography (HR, 3.00; P = 0.047) were identified as predictors for failure. Conclusions: EPA for an isolated, short, anastomotic stricture in transmen is associated with low complication rates, but high failure rates. After 5 years, the estimated FFS rate is 47%. Stricture length, prior urethroplasty, and extravasation at first voiding cystourethrography are predictors for failure.
Keywords
URETHRAL STRICTURES, PHALLOPLASTY, FLAP, URETHROPLASTY, RECONSTRUCTION, COMPLICATIONS

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MLA
Verla, Wesley, et al. “Excision and Primary Anastomosis for Isolated, Short, Anastomotic Strictures in Transmen.” PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN, vol. 8, no. 2, 2020.
APA
Verla, W., Hoebeke, P., Spinoit, A.-F., Waterloos, M., Monstrey, S., & Lumen, N. (2020). Excision and primary anastomosis for isolated, short, anastomotic strictures in transmen. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN, 8(2).
Chicago author-date
Verla, Wesley, Piet Hoebeke, Anne-Françoise Spinoit, Marjan Waterloos, Stan Monstrey, and Nicolaas Lumen. 2020. “Excision and Primary Anastomosis for Isolated, Short, Anastomotic Strictures in Transmen.” PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 8 (2).
Chicago author-date (all authors)
Verla, Wesley, Piet Hoebeke, Anne-Françoise Spinoit, Marjan Waterloos, Stan Monstrey, and Nicolaas Lumen. 2020. “Excision and Primary Anastomosis for Isolated, Short, Anastomotic Strictures in Transmen.” PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 8 (2).
Vancouver
1.
Verla W, Hoebeke P, Spinoit A-F, Waterloos M, Monstrey S, Lumen N. Excision and primary anastomosis for isolated, short, anastomotic strictures in transmen. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN. 2020;8(2).
IEEE
[1]
W. Verla, P. Hoebeke, A.-F. Spinoit, M. Waterloos, S. Monstrey, and N. Lumen, “Excision and primary anastomosis for isolated, short, anastomotic strictures in transmen,” PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN, vol. 8, no. 2, 2020.
@article{8660920,
  abstract     = {Background:
Since the recommendation to perform excision and primary anastomosis (EPA) for isolated, short, anastomotic strictures in transmen, there have been no further reports about its results. This study aims to provide an updated and extended report about the results of EPA for the aforementioned indication.
Methods:
Since 2002, data of all transmen in whom an EPA urethroplasty has been performed at Ghent University Hospital were collected in a database. Exclusion criteria for this analysis were age <18 years old, nonanastomotic strictures, and stricture length >3.0 cm. Postoperative complications were analyzed with descriptive statistics. Failure-free survival (FFS) was analyzed with Kaplan-Meier statistics. Need for further urethral manipulation was used as definition for failure. Potential predictors for failure were entered in a univariate Cox regression analysis.
Results:
In total, 44 patients were included with a median (interquartile range) follow-up of 40 months (7-125 months). Complications after EPA urethroplasty were present in 12 (27%) of the patients and mainly involved low-grade complications (11/44, 25%). After 1, 2, and 5 years, the estimated FFS rate (SD) was 61% (7.8), 61% (7.8), and 47% (9.1). Stricture length (hazard ratio [HR], 2.11; P = 0.03), prior urethroplasty (HR, 3.53; P = 0.008), and extravasation at first voiding cystourethrography (HR, 3.00; P = 0.047) were identified as predictors for failure.
Conclusions:
EPA for an isolated, short, anastomotic stricture in transmen is associated with low complication rates, but high failure rates. After 5 years, the estimated FFS rate is 47%. Stricture length, prior urethroplasty, and extravasation at first voiding cystourethrography are predictors for failure.},
  author       = {Verla, Wesley and Hoebeke, Piet and Spinoit, Anne-Françoise and Waterloos, Marjan and Monstrey, Stan and Lumen, Nicolaas},
  issn         = {2169-7574},
  journal      = {PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN},
  keywords     = {URETHRAL STRICTURES,PHALLOPLASTY,FLAP,URETHROPLASTY,RECONSTRUCTION,COMPLICATIONS},
  language     = {eng},
  number       = {2},
  pages        = {6},
  title        = {Excision and primary anastomosis for isolated, short, anastomotic strictures in transmen},
  url          = {http://dx.doi.org/10.1097/gox.0000000000002641},
  volume       = {8},
  year         = {2020},
}

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