Risk factor analysis of urethral stricture after endoscopic realignment for patients with closed bulbar urethral injury
Objective To investigate the risk factors of urethral stricture after endoscopic realignment(ER)for patients with closed bulbar urethral injury.Methods A retrospective cohort study was conducted to analyze the clinical data of 126 patients with closed bulbar urethral injury who were admitted to 909th Hospital of Joint Logistic Support of PLA from June 2015 to June 2021,aged 20-69 years[(45.1± 12.5)years].The patients were divided into stricture group(n=43)and non-stricture group(n=83)according to whether urethral stricture occurred after ER.Data were compared between the two groups including age,cause of injury,scrotal hematoma,degree of urethral injury,time from injury to operation,times of preoperative catheterization,performance of cystostomy or not before operation,method of endoscopic realignment,length of urethroscopy,traction on the catheter or not after operation,results of postoperative midstream urine culture,etc.Univariate analysis was used to assess the correlation between the aforementioned indexes and urethral stricture after ER.Multivariate Logistic regression analysis was applied to determine the independent risk factors of urethral stricture after ER.Results Univariate analysis showed that there was certain correlation of degree of urethral injury,times of preoperative catheterization,performance of cystostomy or not before operation,length of urethroscopy,and positive results of postoperative midstream urine culture with urethral stricture after ER(P＜0.05 or 0.01).Multivariate Logistic regression analysis showed that complete urethral rupture(OR=4.54,95％CI 1.74,11.86,P＜0.01),preoperative catheterization ≥3 times(OR=2.72,95％CI 1.41,5.25,P＜0.01),length of urethroscopy ≥35 minutes(OR=1.06,95％CI 1.03,1.09,P＜0.01)and positive results of postoperative midstream urine culture(OR=42.99,95％CI 5.91,312.92,P＜0.01)were significantly correlated with urethral stricture after ER.Conclusion Complete urethral rupture,preoperative catheterization ≥3 times,length of urethroscopy ≥35 minutes and positive results of postoperative midstream urine culture are independent risk factors for urethral stricture after ER for patients with closed bulbar urethral injury.
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