Evidence map›Paper›PMID 34046987›Full record

ArticleBJU international2022

Surgical outcomes and proposal for a treatment algorithm for urethral strictures in transgender men.

Freek P W de Rooij, Femke R M Peters, Brechje L Ronkes, Wouter B van der Sluis, Muhammed Al-Tamimi, R Jeroen A van Moorselaar, Mark-Bram Bouman, Garry L S Pigot

Open access · hybridAbstract read
In one paragraph

Article in BJU international, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.

  1. Pooled it
  2. Metoidioplasty in Norway: A 13-year Experience from a National Center.Plastic and reconstructive surgery. Global open · 2024
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Freek P W de RooijDepartment of Urology, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands.ORCID 0000-0002-7878-7371
Femke R M PetersDepartment of Urology, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands.
Brechje L RonkesDepartment of Urology, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands.
Wouter B van der SluisCenter of Expertise on Gender Dysphoria at the Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands.
Muhammed Al-TamimiDepartment of Plastic, Reconstructive and Hand Surgery, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands.
R Jeroen A van MoorselaarDepartment of Urology, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands.
Mark-Bram BoumanCenter of Expertise on Gender Dysphoria at the Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands.
Garry L S PigotDepartment of Urology, Amsterdam University Medical Center, Location VUmc, Amsterdam, the Netherlands.
Amsterdam University Medical Centers · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo assess our results of surgical treatment for urethral strictures in transgender men, and to provide a surgical treatment algorithm. PATIENTS AND

methodsA single centre, retrospective cohort study was conducted of transgender men who underwent surgical correction of their urethral stricture(s) between January 2013 and March 2020. The medical charts of 72 transgender men with 147 urethral strictures were reviewed. The primary outcomes were the success and recurrence rates after surgical treatment for urethral strictures.

resultsThe median (interquartile range [IQR]) follow-up was 61 (25-202) months. At last follow-up, 50/72 (69%) were able to void while standing (after one [60%], two [20%], three [6%], four [8%], five [4%], or seven [2%] procedures), 10/72 (14%) await further treatment, two of the 72 (3%) sat to void despite good urodynamic function, and 10/72 (14%) had a definitive urethrostomy. Of 104 surgical treatments included in separate success rate analysis, 65 (63%) were successful (43/75 [57%] after phalloplasty, 22/29 [76%] after metoidioplasty). The highest success rates in short urethral strictures were seen after a Heineke-Mikulicz procedure (six of seven cases), and in longer or more complicated urethral strictures after two-stage with graft (four of six), two-stage without graft (10/12), pedicled flap (11/15, 73%), and single-stage graft (seven of seven) urethroplasties. Grafts used were buccal mucosa or full-thickness skin grafts. Success rates improved over time, with success rates of 38% and 36% in 2013 and 2014, to 71% and 73% in 2018 and 2019, respectively. We concluded with a surgical treatment algorithm based on previous literature, stricture characteristics, and our surgical outcomes.

conclusionThe highest success rates were seen after a Heineke-Mikulicz procedure in short urethral strictures; and after graft, pedicled flap, or two-stage urethroplasties in longer or more complicated urethral strictures. Finally, most of the transgender men were able to void while standing, although in some multiple surgical procedures were necessary to accomplish this.

Indexed as

AlgorithmsAdultAnastomosis, SurgicalFemaleFollow-Up StudiesGender-Affirming SurgeryHumansMalePenisReoperationRetrospective StudiesTransgender PersonsTreatment OutcomeUrethraUrethral StrictureUrinationgenital gender-affirming surgerymetoidioplastyphalloplastysurgical outcometransgender mentreatment algorithmurethral stricture

Identifiers

PMID34046987
PMCPMC9291467
OpenAlexW3164634138

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.