Scand J Urol. 2018 Nov 1:1-7. doi: 10.1080/21681805.2018.1505945. [Epub ahead of print]

Sclerosis as a predictive factor for failure after bulbar urethroplasty: a prospective single-centre study.

Ekerhult TO¹, Lindqvist K¹, Grenabo L¹, Kåbjörn Gustafsson C², Peeker R¹.

Author information:
1. a Department of Urology , Institute of Clinical Sciences at Sahlgrenska Academy, Sahlgrenska University Hospital , Gothenburg , Sweden.
2. b Department of Pathology , Institute of Clinical Sciences at Sahlgrenska Academy, Sahlgrenska University Hospital , Gothenburg , Sweden.

Abstract

OBJECTIVE:

The aim of this study was to assess whether sclerosis in histology following bulbar urethroplasty is a predictive factor for failure of surgery.

MATERIALS AND METHODS:

Resected stricture specimens from 45 patients undergoing open urethroplasty with excision and anastomosis were collected prospectively during 2011-2014. Histopathological characteristics, including fibrosis (grade I-III), inflammation and sclerosis, were evaluated using different routine staining. These specimens were compared to normal urethral resection specimens from patients undergoing sex-correction surgery. The uropathologist who conducted the analyses was blinded to the study design.

RESULTS:

The outcomes of the histological classifications were as follows: 19 patients had grade I fibrosis, of whom three had failures; 13 patients had grade II fibrosis, without any failures; and the most severe fibrosis, grade III, including sclerosis, was found in 13 patients (11 with sclerosis), with failure in eight. Sclerosis was a significant risk factor for restricture when comparing patients with sclerosis and those without sclerosis, and likewise when adjusting for age, inflammation and stricture length.

CONCLUSION:

Histological findings of sclerosis in the resected urethral stricture specimen indicate a significantly higher risk for restricture after urethroplasty surgery.