{"id":1034,"date":"2020-08-14T12:06:16","date_gmt":"2020-08-14T12:06:16","guid":{"rendered":"https:\/\/cru.aeu.es\/?p=1034"},"modified":"2020-08-14T12:10:55","modified_gmt":"2020-08-14T12:10:55","slug":"recurrencia-de-estenosis-de-uretra","status":"publish","type":"post","link":"https:\/\/cru.aeu.es\/?p=1034","title":{"rendered":"Recurrencia de estenosis de uretra."},"content":{"rendered":"

Eur Urol. 2020 Jul 4. pii: S0302-2838(20)30430-9. doi: 10.1016\/j.eururo.2020.06.003. [Epub ahead of print]<\/p>\n

Surgical Treatment for Recurrent Bulbar Urethral Stricture: A Randomised Open-label Superiority Trial of Open Urethroplasty Versus Endoscopic Urethrotomy (the OPEN Trial).<\/b><\/span><\/span><\/span><\/a><\/u><\/span><\/span><\/h1>\n

Goulao B<\/span><\/a><\/u><\/span><\/span>1<\/span><\/sup>,\u00a0Carnell S<\/span><\/a><\/u><\/span><\/span>2<\/span><\/sup>,\u00a0Shen J<\/span><\/a><\/u><\/span><\/span>3<\/span><\/sup>,\u00a0MacLennan G<\/span><\/a><\/u><\/span><\/span>4<\/span><\/sup>,\u00a0Norrie J<\/span><\/a><\/u><\/span><\/span>5<\/span><\/sup>,\u00a0Cook J<\/span><\/a><\/u><\/span><\/span>6<\/span><\/sup>,\u00a0McColl E<\/span><\/a><\/u><\/span><\/span>3<\/span><\/sup>,\u00a0Breckons M<\/span><\/a><\/u><\/span><\/span>3<\/span><\/sup>,\u00a0Vale L<\/span><\/a><\/u><\/span><\/span>7<\/span><\/sup>,\u00a0Whybrow P<\/span><\/a><\/u><\/span><\/span>8<\/span><\/sup>,\u00a0Rapley T<\/span><\/a><\/u><\/span><\/span>9<\/span><\/sup>,\u00a0Forbes R<\/span><\/a><\/u><\/span><\/span>2<\/span><\/sup>,\u00a0Currer S<\/span><\/a><\/u><\/span><\/span>2<\/span><\/sup>,\u00a0Forrest M<\/span><\/a><\/u><\/span><\/span>4<\/span><\/sup>,\u00a0Wilkinson J<\/span><\/a><\/u><\/span><\/span>2<\/span><\/sup>,\u00a0Andrich D<\/span><\/a><\/u><\/span><\/span>10<\/span><\/sup>,\u00a0Barclay S<\/span><\/a><\/u><\/span><\/span>11<\/span><\/sup>,\u00a0Mundy A<\/span><\/a><\/u><\/span><\/span>10<\/span><\/sup>,\u00a0N’Dow J<\/span><\/a><\/u><\/span><\/span>12<\/span><\/sup>,\u00a0Payne S<\/span><\/a><\/u><\/span><\/span>13<\/span><\/sup>,\u00a0Watkin N<\/span><\/a><\/u><\/span><\/span>14<\/span><\/sup>,\u00a0Pickard R<\/span><\/a><\/u><\/span><\/span>15<\/span><\/sup>.<\/p>\n

Abstract<\/b><\/span><\/span><\/span><\/h3>\n

BACKGROUND:\u00a0<\/b><\/span><\/span><\/span><\/h4>\n

Urethral stricture affects 0.9% of men. Initial treatment is urethrotomy. Approximately, half of the strictures recur within 4\u202fyr. Options for further treatment are repeat urethrotomy or open urethroplasty.<\/span><\/span><\/span><\/p>\n

OBJECTIVE:\u00a0<\/b><\/span><\/span><\/span><\/h4>\n

To compare the effectiveness and cost-effectiveness of urethrotomy with open urethroplasty in adult men with recurrent bulbar urethral stricture.<\/span><\/span><\/span><\/p>\n

DESIGN, SETTING, AND PARTICIPANTS:\u00a0<\/b><\/span><\/span><\/span><\/h4>\n

This was an open label, two-arm, patient-randomised controlled trial. UK National Health Service hospitals were recruited and 222 men were randomised to receive urethroplasty or urethrotomy.<\/span><\/span><\/span><\/p>\n

INTERVENTION:\u00a0<\/b><\/span><\/span><\/span><\/h4>\n

Urethrotomy is a minimally invasive technique whereby the narrowed area is progressively widened by cutting the scar tissue with a steel blade mounted on a urethroscope. Urethroplasty is a more invasive surgery to reconstruct the narrowed area.<\/span><\/span><\/span><\/p>\n

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS:\u00a0<\/b><\/span><\/span><\/span><\/h4>\n

The primary outcome was the profile over 24 mo of a patient-reported outcome measure, the voiding symptom score. The main clinical outcome was time until reintervention.<\/span><\/span><\/span><\/p>\n

RESULTS AND LIMITATIONS:\u00a0<\/b><\/span><\/span><\/span><\/h4>\n

The primary analysis included 69 (63%) and 90 (81%) of those allocated to urethroplasty and urethrotomy, respectively. The mean difference between the urethroplasty and urethrotomy groups was -0.36 (95% confidence interval [CI] -1.74 to 1.02). Fifteen men allocated to urethroplasty needed a reintervention compared with 29 allocated to urethrotomy (hazard ratio [95% CI] 0.52 [0.31-0.89]).<\/span><\/span><\/span><\/p>\n

CONCLUSIONS:\u00a0<\/b><\/span><\/span><\/span><\/h4>\n

In men with recurrent bulbar urethral stricture, both urethroplasty and urethrotomy improved voiding symptoms. The benefit lasted longer for urethroplasty.<\/span><\/span><\/span><\/p>\n

PATIENT SUMMARY:\u00a0<\/b><\/span><\/span><\/span><\/h4>\n

There was uncertainty about the best treatment for men with recurrent bulbar urethral stricture. We randomised men to receive one of the following two treatment options: urethrotomy and urethroplasty. At the end of the study, both treatments resulted in similar and better symptom scores. However, the urethroplasty group had fewer reinterventions.<\/span><\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

Eur Urol. 2020 Jul 4. pii: S0302-2838(20)30430-9. doi: 10.1016\/j.eururo.2020.06.003. [Epub ahead of print] Surgical Treatment for Recurrent Bulbar Urethral Stricture: A Randomised Open-label Superiority Trial of Open Urethroplasty Versus Endoscopic Urethrotomy (the OPEN Trial). Goulao B1,\u00a0Carnell S2,\u00a0Shen J3,\u00a0MacLennan G4,\u00a0Norrie J5,\u00a0Cook …<\/p>\n

Recurrencia de estenosis de uretra.<\/span> Leer m\u00e1s \u00bb<\/a><\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-1034","post","type-post","status-publish","format-standard","hentry","category-adulto-uretra"],"_links":{"self":[{"href":"https:\/\/cru.aeu.es\/index.php?rest_route=\/wp\/v2\/posts\/1034","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cru.aeu.es\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cru.aeu.es\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cru.aeu.es\/index.php?rest_route=\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/cru.aeu.es\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=1034"}],"version-history":[{"count":1,"href":"https:\/\/cru.aeu.es\/index.php?rest_route=\/wp\/v2\/posts\/1034\/revisions"}],"predecessor-version":[{"id":1035,"href":"https:\/\/cru.aeu.es\/index.php?rest_route=\/wp\/v2\/posts\/1034\/revisions\/1035"}],"wp:attachment":[{"href":"https:\/\/cru.aeu.es\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=1034"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cru.aeu.es\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=1034"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cru.aeu.es\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=1034"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}