Mucosa grafts urethroplasty in hypospadias-associated urethral stricture: critical factors for treatment selection

This research aimed to identify factors affecting outcomes of hypospadias-associated urethral stricture repair, and to find the best surgical method for overweight and obese patients. There were 188 patients who were admitted in this study. Multivariable analysis was performed by logistic regression with the success rate as the dependent variable. Multivariate linear regression was performed, and the spearman value was used to evaluate the linear regression. Stratified analysis was adopted depending on BMI (Body mass index) status. The MantelHaenszel (M-H) test and Breslow-Day (B-D) test were used to test the homogeneity of OR (Odds ratio). Kaplan-Meier (K-M) curves were plotted. The BMI status (OR=0.233, 95% CI=0.090-0.600, P=0.003) and the number of previous operations (OR=0.140, 95% CI=0.056-0.351, P=0.000) were independently associated with success rate. A two-stage method had higher success rate than one-stage in the overweightness & obesity group (OR=4.911, 95% CI=1.504-16.036, P=0.004). There was a significant difference in homogeneity (M-H test, P=0.029; B-D test, P=0.026). “Treatment (P=0.007)” in overweight & obese group, “BMI (P=0.000)”, “numbers of previous operations (P=0.000)” were associated with unsuccessful-free survival rates. This research suggested that a two-stage method had a higher success rate for overweight and obese patients while both oneand two-stage achieved satisfied outcomes in BMI-normal patients.