The definition of stricture recurrence after DVIU or urethroplasty remains variable in the literature, which makes the comparison of outcomes difficult. The purpose of this study was to provide a contemporary literature review of the definition of stricture recurrence.
The authors performed a systemic review via PubMed of English, peer-reviewed articles from 2009-2014. There were 39 studies that fit the inclusion criteria, 26 regarding urethroplasty and 13 regarding DVIU. Definitions of recurrence included the need for repeat procedure or instrumentation, the inability to pass a 16-18 french cystoscope, decreasing Qmax, and stricture on ultrasound. In 50% of the urethroplasty studies, stricture recurrence was defined as the need for repeat procedure or instrumentation. In 38.5% of the DVIU studies, stricture recurrence was defined as a decrease in Qmax. There was considerable variability in the timing and consistency of follow-up across all studies.
The author recommended a combined approach for evaluating patients for stricture recurrence that consists of obtaining an AUA symptom score and only performing cystoscopy or uroflow if there are bothersome symptoms. Dr Sherer advocated for the development of a standardized system that takes into account cost, patient comfort, and the sensitivity and specificity of diagnostic tests.
Presented by Benjamin Sherer (Rush) American Urological Association (AUA) Annual Meeting May 6-10, 2016 San Diego, CA
Reported by Lisa Parrillo (University of Pennsylvania) American Urological Association (AUA) Annual Meeting May 6-10, 2016 San Diego, CA