Investig Clin Urol.  2020 Sep;61(5):508-513. 10.4111/icu.20200076.

Learning curve of various type of male urethroplasty

Affiliations
  • 1Department of Urology, VHS Medical Center, Seoul, Korea
  • 2Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Abstract

Purpose
To determine the number of cases required to achieve a specified recurrence-free rate (>80%) among urethroplasty types.
Materials and Methods
A retrospective analysis of consecutive patients, who underwent urethroplasty performed by a single surgeon between April 2013 and January 2019, was conducted. Urethroplasty subtypes were divided according to stricture location: penile, bulbar, and posterior. If there was no recurrence for >6 months after surgery, the surgery was considered to be a success. The average success rates among quintile groups were compared to determine the learning curve for each type.
Results
Of 150 patients who underwent urethroplasty, 112 were included in this study. The overall success rate was 89.7% in penile, 97.8% in bulbar, and 74.1% in posterior urethroplasty. Bulbar urethroplasty reached the target success rate in the first quintile group (1–9 cases). Penile urethroplasty also achieved the target success rate in the first quintile group (1–8 cases), and the success rate gradually increased until the fifth quintile group (32–39 cases). In posterior urethroplasty, the target success rate was achieved in the fifth quintile group (20–27 cases).
Conclusions
Bulbar urethroplasty had the fastest learning curve, and posterior urethroplasty the slowest.

Keyword

Learning curve; Reconstructive surgical procedures; Urethral stricture
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