Assessment of long term outcomes after buccal mucosal graft urethroplasty: the impact of chronic kidney disease

Vol. 45 (5): 981-988, September – October, 2019

doi: 10.1590/S1677-5538.IBJU.2019.0176


ORIGINAL ARTICLE

Manoj Kumar 1, Ajay Aggarwal 1, Siddharth Pandey 1, Samarth Agarwal 1, Satya Narayan Sankhwar 1
1 Department of Urology, King George’s Medical University, Lucknow, INDIA

ABSTRACT

Objectives: To compare and assess various outcomes and success of buccal mucosal graft urethroplasty (BMGU) in patients with CKD versus patients having normal renal function.
Material and Methods: This was a retrospective, single centre study, during period 2013 to 2017. Patients were grouped into two groups. Group 1 had patients with estimated Glomerular Filtration Rate (eGFR)>60mL/min/1.73m2 while group 2 had patients with eGFR <60mL/min/1.73m2. eGFR was calculated according to the MDRD equation. The two groups were compared with regard to various outcomes like length, location of stricture, technique of graft placement, intra-operative blood loss (haemoglobin drop), duration of hospital stay, post-operative complications and recurrence.
Results: A total of 223 patients were included in study with group 1 had 130 patients and group 2 had 93 patients. Mean age of patients with CKD were higher (47.49 years versus 29.13 years). The mean follow-up period was comparable between both groups (23.29 months and 22.54 months respectively). Patients with CKD had more post-operative Clavien Grade 2 or higher complications (p=0.01) and a greater recurrence rates (p<0.001) than in non-CKD patients. On multivariate analysis, age and CKD status was signifi cant predictor of urethroplasty success (p=0.004) (OR= 14.98 (1.952-114.94, 95% CI).
Conclusions: CKD patients are more prone to post-operative complications in terms of wound infection, graft uptake and graft failure and higher recurrence rates following BMGU.

Keywords: Oral Mucosal Absorption; Renal Insuffi ciency, Chronic; Kidney Glomerulus

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