U‐score system for predicting time to recurrence after urethral reconstruction in patients with anterior urethral stricture

Mitsui, Yozo; Kobayashi, Hideyuki; Hori, Shunsuke; Iwai, H.; Nakajima, Koichi; Nagao, Kōichi

doi:10.1111/iju.13790

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…We suspect that had we performed a univariable logistic regression analysis of our cohort we might have observed a similar result to Alwaal et al 22 An abstract detailing the results of a small series of 29 patients did demonstrate a relationship using a Cox PH model; however, the full manuscript was not available for review. 23 Similar to several other studies, however, we did observe a significant relationship between U-Score and intraoperative surgical complexity. 24 We believe that while U-Score is not associated with postoperative outcomes, this simple easy-to-calculate score is valuable for daily use in counseling patients on intraoperative expectations and in guiding surgical planning.…”

Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

“…Although we did not find an association between U-Score and recurrence, prior studies have suggested that this relationship exists. 13,[22][23][24] In a cohort of 341 patients, Alwaal et al reported that U-Score was significantly associated with recurrence risk when using a univariable logistic regression model. 22 However, similar to our result, the authors did not observe a significant association when using a Cox PH modeldwhich takes postoperative time, follow-up, and attrition into account.…”

Section: Discussionmentioning

confidence: 99%

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Evaluating Tools for Characterizing Anterior Urethral Stricture Disease: A Comparison of the LSE System and the Urethral Stricture Score

et al. 2022

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Purpose: We evaluated if scores generated by the LSE classification system and the Urethral Stricture Score system are associated with intraoperative surgical complexity and stricture recurrence risk. Materials and Methods: We retrospectively reviewed all consenting patients who underwent single-stage anterior urethroplasty by a single surgeon at 2 institutions. Urethral Stricture Score and a numerical LSE "score" was calculated for each patient. Pearson's correlation and linear regression analyses were used to assess for a relationship between increasing Urethral Stricture Score and LSE score and surgical complexity. Kaplan-Meier curves and Cox proportional hazard regression models were used to assess for an association between Urethral Stricture Score and LSE score and stricture recurrence risk. Results: A total of 187 patients with a mean age of 48 years (SD 16) and mean stricture length of 4.2 cm (SD 3.3) were included. Mean follow-up was 21 months. Forty-six patients recurred over time. We found a strong positive linear correlation between Urethral Stricture Score and LSE score (P < .001). Both increasing Urethral Stricture Score and LSE score independently linearly correlated with increasing surgical complexity (both P < .0001). Univariable analysis demonstrated that increasing LSE score was significantly associated with an increased risk of stricture recurrence (HR 1.2, P [ .02) but Urethral Stricture Score was not. Patients with a high LSE score (7) were nearly 3 times as likely to recur versus patients with a low LSE score (HR 2.7, P [ .001). Conclusions: Increasing Urethral Stricture Score and LSE score are both associated with increasing surgical complexity, but only LSE score is associated with stricture recurrence risk. Conversion of the LSE classification system into a numeric score adds functionality to this novel system.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Evaluating Tools for Characterizing Anterior Urethral Stricture Disease: A Comparison of the LSE System and the Urethral Stricture Score

et al. 2022

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“…The score was later modified and renamed as 'U score' by Eswara and colleagues in 2015 with the elimination of the urinary retention component. The new modified U score also showed a correlation with operation complexity and operation time [9][10][11] Describes demographic and stricture characteristics of Nigerian cohort based on RUG and describes the proposed gombe urethrographic score recurrence has not been well established, with conflicting results among validation studies [10,11]. Both USS and the updated U score are well-rounded validated scoring systems for urethral strictures.…”

Section: Urethral Stricture Score (Uss) [7] (Table 3)mentioning

confidence: 99%

Classification systems for anterior urethral stricture disease in men: a systematic review

John

Kahokehr

2020

World J Urol

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Objective To identify and explore the various classification systems that have been proposed for anterior urethral stricture disease (AUSD) and to identify the advantages and disadvantages of each. Methods A comprehensive systematic review was conducted in MEDLINE, EMBASE, SCOPUS and COCHRANE databases with a search strategy created appropriately. Titles and abstracts of search results were screened by two authors and selected for full-text review. Studies exploring urethral stricture classification, clinical scoring or staging systems used in men over the age of 18 with benign anterior urethral stricture disease were included. Results The search identified 3113 articles, of which 10 were selected for inclusion after scrutiny. Four classification systems were identified. These include ULTRA score, urethral stricture score, cystoscopy-based staging system and Gombe Urethrographic score. These were based on various modalities, including cystoscopy, retrograde urethrogram (RUG) and sonourethrogram (SUG). From the scoring systems identified, the urethral stricture scoring system has multiple external validation studies and is predictive of operative complexity, operative time, recurrence and postoperative complications. Conclusions Several classification systems have been proposed for AUSD. Each has its advantages and disadvantages. The urethral stricture score has been externally validated and shown to been predictive of surgical outcomes and recurrence. There are no scores that incorporate patient-related outcome measures (PROMs). Many classification systems have yet to provide sufficient external validation. Further external validation studies are needed before the general adoption of a particular system.

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U-Score auch zum Abschätzen des Rezidivrisikos anteriorer Strikturen

Bublak¹

2018

Uro-News

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U‐score system for predicting time to recurrence after urethral reconstruction in patients with anterior urethral stricture

Cited by 5 publications

References 7 publications

Evaluating Tools for Characterizing Anterior Urethral Stricture Disease: A Comparison of the LSE System and the Urethral Stricture Score

Evaluating Tools for Characterizing Anterior Urethral Stricture Disease: A Comparison of the LSE System and the Urethral Stricture Score

Classification systems for anterior urethral stricture disease in men: a systematic review

U-Score auch zum Abschätzen des Rezidivrisikos anteriorer Strikturen

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