Skip to main content
eScholarship
Open Access Publications from the University of California

UCSF

UC San Francisco Previously Published Works bannerUCSF

The cost of surveillance after urethroplasty.

  • Author(s): Zaid, Uwais B
  • Hawkins, Mitchel
  • Wilson, Leslie
  • Ting, Jie
  • Harris, Catherine
  • Alwaal, Amjad
  • Zhao, Lee C
  • Morey, Allen F
  • Breyer, Benjamin N
  • et al.
Abstract

Objective

To determine variability in urethral stricture surveillance. Urethral strictures impact quality of life and exact a large economic burden. Although urethroplasty is the gold standard for durable treatment, strictures recur in 8%-18%. There are no universally accepted guidelines for posturethroplasty surveillance. We performed a literature search to evaluate variability in surveillance protocols, analyzed costs, and reviewed performance of each commonly used modality.

Methods

MEDLINE search was performed using the keywords "urethroplasty," "urethral stricture," and "stricture recurrence" to ascertain commonly used surveillance strategies for stricture recurrence. We included English language articles from the past 10 years with at least 10 patients, and age >18 years. Cost data were calculated based on standard 2013 Centers for Medicare and Medicaid Services physician's fees.

Results

Surveillance methods included retrograde urethrogram or voiding cystourethrogram, cystourethroscopy, urethral ultrasound, American Urological Association Symptom Score, and postvoid residual and urine flowmetry (UF) measurement. Most protocols call for a retrograde urethrogram or voiding cystourethrogram at the time of catheter removal. After this, UF or PVR, cystoscopy, urine culture, or a combination of UF and American Urological Association Symptom Score was performed at variable intervals. The first-year follow-up cost of anterior urethral surgery ranged from $205 to $1784. For posterior urethral surgery, follow-up cost for the first year ranged from $404 to $961.

Conclusion

Practice variability for surveillance of urethral stricture recurrence after urethroplasty leads to significant differences in cost.

Many UC-authored scholarly publications are freely available on this site because of the UC's open access policies. Let us know how this access is important for you.

Main Content
Current View