Researchers looked at whether intraoperative surgical complexity and stricture recurrence risk are correlated with scores produced by the LSE classification system and the Urethral Stricture Score system. In addition, they looked back at the medical records of all patients who had a single-stage anterior urethroplasty performed at either of 2 hospitals.
Each patient was given a numerical LSE “score” in addition to their Urethral Stricture Score. There was an attempt to determine if there was a correlation between the Urethral Stricture Score and the Surgical Effort Score by using Pearson’s correlation and linear regression analyses. Recurrence risk was compared between the Urethral Stricture Score and the LSE score using Kaplan-Meier curves and Cox proportional hazard regression models. Patients’ average age was 48 (SD 16), and their stricture length was 4.2 cm (SD 3.3). The average duration of follow-up was 21 months.
After a period of time, 46 patients experienced a recurrence. Urethral stricture severity was positively correlated with LSE (P< .001). Surgical complexity increased linearly with both the Urethral Stricture Score and the Lumbar Spine Injury score (P< .0001). In univariate analysis, stricture recurrence was found to be substantially linked with rising LSE score (HR 1.2, P =.02) but not with increasing Urethral Stricture Score. Recurrence rates were nearly 3 times as high in patients with high LSE scores (≥7) as in those with low LSE scores (HR 2.7, P =.001).
Both the Urethral Stricture Score and the LSE score go up with the severity of the stricture. However, only the LSE score is related to the likelihood of the stricture returning after surgery. Therefore, the innovative LSE classification system is made more useful by being converted into a numerical score.