title: Stricture recurrence after urethroplasty: a systematic review.
abstract: OBJECTIVE
  Urethroplasty remains the gold standard for the management of urethral stricture disease with acceptable long-term success. However, the standard by which stricture recurrence is defined and evaluated after urethral reconstruction remains widely variable. We conducted a systematic review of the urological literature to determine how stricture recurrence is defined and evaluated.
  
  
  METHODS
  A systematic review was conducted on all contemporary urethroplasty articles published between 2000 and 2008. Using the term "urethroplasty" 302 articles were identified and evaluated. A total of 86 articles were included in the analysis.
  
  
  RESULTS
  The overall recurrence rate for all reconstructive procedures was 15.6%, which remained stable between 2000 and 2008. Stricture recurrence was determined by a mean of 3 (range 1 to 8) different diagnostic tests. The most common primary diagnostic tests for recurrence were uroflowmetry (56% of articles) and retrograde urethrography (51%). Cystourethroscopy was used as a primary screen to identify stricture recurrence in 25% of articles, and as a secondary procedure in another 21%. Recurrence was defined as the need for an additional surgical procedure or dilation in 75% and 52% of articles, respectively.
  
  
  CONCLUSIONS
  The methods used to determine stricture recurrence after urethroplasty remain widely variable. The use of a standardized surveillance protocol to define stricture recurrence after urethral reconstruction may allow more effective comparison of urethroplasty outcomes across institutions.
authors.affiliation: Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois 60611, USA.
authors.forename: Joshua J
authors.initials: JJ
authors.lastname: Meeks
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Erickson
authors.forename: Michael A
authors.initials: MA
authors.lastname: Granieri
authors.forename: Chris M
authors.initials: CM
authors.lastname: Gonzalez
mesh_terms: D006801:Humans; D008297:Male; D012008:Recurrence; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods