title: Multicenter Analysis of Urinary Urgency and Urge Incontinence in Patients with Anterior Urethral Stricture Disease before and after Urethroplasty.
abstract: Little published data exist on the impact of urethral stricture surgery on urinary urgency. We evaluated urinary urgency and urge incontinence before and after anterior urethroplasty.
  
  
  
  Male patients who underwent 1-stage anterior urethroplasty were retrospectively identified at 8 centers. Patients with preoperative and 2-month or greater postoperative subjective urinary urgency assessments were included in study. Patients who received anticholinergic medications preoperatively were excluded. Univariate and multivariate analysis was done to analyze the association of patient characteristics with preoperative and postoperative symptoms as well as improvement or worsening of symptoms after surgery.
  
  
  
  Symptom and followup data on urgency and urge incontinence were available in in 439 and 305 patients, respectively. Preoperatively 58% of the men reported urgency and 31% reported urge incontinence. Postoperatively this decreased to 40% of men for urgency and 12% for urge incontinence (each p <0.01). Of the men 37% reported improvement in urgency and 74% experienced improvement in urge incontinence. Few of those without preoperative symptoms showed worse symptoms, including urgency in 9% and urge incontinence in 5%. New urgency was more likely to develop in men with a higher body mass index (OR 1.09, p = 0.02). Men with stricture recurrence were less likely to show improvement in urgency (OR 0.24, p = 0.03). Older men were more likely to have new urge incontinence (OR 1.06, p = 0.01) and less likely to notice improvement in urge symptoms (OR 0.92, p <0.01).
  
  
  
  The prevalence of urgency and urge incontinence in male patients with anterior urethral stricture is high. The majority of men experience symptom stability or improvement in urinary urge symptoms following anterior urethroplasty.
authors: Department of Urology, University of California-San Francisco, San Francisco, California.
authors: Lindsay A
authors: LA
authors: Hampson
authors: Department of Urology, University of Minnesota, Minneapolis, Minnesota.
authors: Sean P
authors: SP
authors: Elliott
authors: Department of Urology, University of Iowa, Iowa City, Iowa.
authors: Bradley A
authors: BA
authors: Erickson
authors: Department of Urology, Lahey Clinic Medical Center, Burlington, Massachusetts.
authors: Alex J
authors: AJ
authors: Vanni
authors: Division of Surgery, Department of Urology, University of Utah, Salt Lake City, Utah.
authors: Jeremy B
authors: JB
authors: Myers
authors: Department of Urology, Ohio State University Medical Center, Columbus, Ohio.
authors: Christopher
authors: C
authors: McClung
authors: Department of Urology, University of California-San Francisco, San Francisco, California.
authors: Benjamin N
authors: BN
authors: Breyer
authors: Department of Urology, Baylor College of Medicine, Houston, Texas.
authors: Thomas G
authors: TG
authors: Smith
authors: Department of Urology, University of Washington, Seattle, Washington.
authors: Judith C
authors: JC
authors: Hagedorn
authors: Department of Urology, Harborview Medical Center, Seattle, Washington. Electronic address: voelzke@uw.edu.
authors: Bryan B
authors: BB
authors: Voelzke
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*; D012189:Retrospective Studies; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000150:complications / Q000601:surgery*; D053202:Urinary Incontinence, Urge / Q000453:epidemiology* / Q000209:etiology; D013521:Urologic Surgical Procedures, Male
keywords: lower urinary tract symptoms; overactive; urethra; urethral stricture; urge; urinary bladder; urinary incontinence