Simple urethral dilatation, endoscopic urethrotomy, and urethroplasty for urethral stricture disease in adult men

Susan SW Wong; Omar M Aboumarzouk; Radhakrishna Narahari; Anna O'Riordan; Robert Pickard

doi:10.1002/14651858.CD006934.pub3

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Figure 1

Flow chart of article selection process.

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Figure 2

Risk of bias graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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Figure 3

Risk of bias summary: review authors' judgements about each risk of bias item for each included study.

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Analysis 1.6

Comparison 1 Urethrotomy versus urethral dilatation, Outcome 6 Adverse Events ‐ Overall.

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Analysis 1.7

Comparison 1 Urethrotomy versus urethral dilatation, Outcome 7 Adverse Events During Performance of Procedure‐ Types of Complication.

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Analysis 1.8

Comparison 1 Urethrotomy versus urethral dilatation, Outcome 8 technical failure during procedure (procedure abandoned).

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Analysis 2.1

Comparison 2 Urethrotomy versus urethroplasty, Outcome 1 Recurrence of stricture requiring further surgery.

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Analysis 2.7

Comparison 2 Urethrotomy versus urethroplasty, Outcome 7 Adverse Events ‐ Types of Complication.

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Analysis 2.8

Comparison 2 Urethrotomy versus urethroplasty, Outcome 8 technical failure during procedure (procedure abandoned).

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Comparison 1. Urethrotomy versus urethral dilatation

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Recurrence of stricture requiring further surgery	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Interval between first treatment and need for further treatment	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Stricutre Free Rate	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.1 At 3 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.2 At 6 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.3 At 9 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.4 At 12 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.5 At 24 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.6 At 36 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
3.7 At 48 months	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 Qmax (Mean ml/s)	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Symptomatic improvement post intervention	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Adverse Events ‐ Overall Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

7 Adverse Events During Performance of Procedure‐ Types of Complication Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

7.1 Difficult (Tight Stricture)	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.2 Haemorrhage/Haematoma	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.3 False Passage	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.4 Extravasation	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.5 Pain	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.6 Knotting of Filiform Leader	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.7 Breaking of Filiform Leader	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.8 Bending of Filiform Leader	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 technical failure during procedure (procedure abandoned) Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

9 Length of Hospital Stay	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Length of Catheterisation	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
11 Operative Time	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Quality of Life	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
13 Costs, Resource Use and formal measures of cost‐effectiveness	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 1. Urethrotomy versus urethral dilatation

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Comparison 2. Urethrotomy versus urethroplasty

Outcome or subgroup title	No. of studies	No. of participants	Statistical method	Effect size
1 Recurrence of stricture requiring further surgery Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

1.1 at six months	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.2 at one year	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
1.3 at two years	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
2 Interval between first treatment and need for further treatment	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
3 Stricutre Free Rate	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
4 flow rate ‐ Qmax (Mean ml/s)	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
5 Symptomatic improvement post intervention	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
6 Adverse Events ‐ Overall	0	0	Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7 Adverse Events ‐ Types of Complication Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

7.1 Difficult (Tight Stricture)	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.2 Haemorrhage	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.3 False Passage	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.4 Extravasation	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.5 Pain	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.6 Knotting of Filiform Leader	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.7 Breaking of Filiform Leader	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.8 Bending of Filiform Leader	0		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.9 Sepsis	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
7.10 Rectal Injury	1		Risk Ratio (M‐H, Fixed, 95% CI)	0.0 [0.0, 0.0]
8 technical failure during procedure (procedure abandoned) Show forest plot	1		Risk Ratio (M‐H, Fixed, 95% CI)	Totals not selected

9 Length of Hospital Stay	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
10 Length of Catheterisation	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
11 Operative Time	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
12 Quality of Life	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]
13 Costs, Resource Use and formal measures of cost‐effectiveness	0	0	Mean Difference (IV, Fixed, 95% CI)	0.0 [0.0, 0.0]

Comparison 2. Urethrotomy versus urethroplasty

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