Abstracts from the Abstracts from the Mid-Atlantic Section of the AUA 2021

© The Canadian Journal of Urology TM : International Supplement, October 2021 Display Posters Shear Wave Elastography: Novel Methods for the Evaluation of Urethral Stricture Disease J. Leong, C. Wessner, P. Machado, E. Trabulsi, E. Halpern, F. Forsberg, J. Eisenbrey, P. Chung Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA Introduction and Objective: Shear wave elastography (SWE) is a technique for measuring tissue stiffness noninvasively and may be utilized to evaluate spongiofibrosis. We examined the utility of SWE for the evaluation of urethral stricture disease. Methods: Patients with a single, bulbar urethral stricture were prospectively recruited fromOctober 2018 to October 2020. SWE was performed at the time of surgical repair and at 4 months follow-up using an Aplio i800 scanner (Canon Medical Systems, Tustin, CA) with an i8CX1 transducer. Upon imaging acquisition, four regions of interest were placed on the corpus spongiosum – both ventrally and dorsally at the level of the stricture and adjacent to the stricture in healthy tissue (Figure 1). Tissue stiffness (in kPa) was averaged across the corresponding ROIs in 3 separate images for each patient. SWE data were analyzed using paired student’s t-tests. Results: Thirty men were enrolled. Pre-operatively, tissue stiffness of the corpus spongiosum was greater at the level of the stricture (32.6±5.4 kPa vs. 27.3±3.8 kPa, p=0.04). and in narrower (<5 Fr) strictures (48.1±6.6 kPa vs. 26.5±4.8 kPa, p=0.04), but did not differ by stricture length (p=0.18). Post- operative tissue was less stiff than pre-operative measurements at both the stricture (19.4±3.2 kPa vs. 32.6±5.4 kPa, p<0.001) and non-strictured areas (20.0±2.8 kPa vs. 27.3±3.8 kPa, p=0.007). Pre-operatively, stricture stiffness was not a predictor for recurrence (5/15; recurrence, 32.7±5.3 kPa vs. 10/15; no recurrence, 29.2±5.0 kPa, p=0.6). Tissue stiffness post-operatively was greater in patients who underwent excision and primary anastomosis vs. non-transecting and buccal graft urethroplasty (14/28; 26.5±4.0 kPa vs. 13/28; 8.8±1.2 kPa, p<0.001). Conclusions: SWE may be a useful complement to conventional ultrasound in the initial characterization and post-operative follow-up of urethral stricture disease. Preoperative Predictors of Surgical Success for Robotic Ureteral Reconstruction of Proximal and Middle Ureteral Strictures M. Lee 1 , R. Fromer 1 , Z. Lee 1 , A. Asghar 1 , R. Lee 1 , D. Strauss 1 , L. Zhao 2 , M. Stifelman 3 , D. Eun 1 1 Temple University Hospital, Philadelphia, PA, USA; 2 NewYork University Langone, New York, NY, USA; 3 Hackensack UniversityMedical Center, Hackensack, NJ, USA Introduction and Objective: We investigate predictors of surgical success for patients undergoing robotic ureteral reconstruction (RUR) for proximal and middle ureteral stricture disease. Methods: We retrospectively reviewed our multi-institutional Collaborative of Reconstructive Robotic Ureteral Surgery (CORRUS) database to identify all consecutive patients undergoing RUR for proximal and/or middle ureteral stricture disease between 04/2012-01/2019. The specific reconstruction technique was determined by the primary surgeon based on clinical history and intraoperative findings. Patients were grouped according to whether or not they were surgical successful. Preoperative variables between both groups were compared using chi-square tests. All independent variables with associations of p<0.2 then underwent a binary logistic regression analysis to determine predictive variables of success for RUR (p≤0.05 was considered statistically significant). Results: Overall, 228 patients met inclusion criteria. Univariate analysis (Table 1) showed that there were a lower proportion of patients with diabetes (8.5% versus 29.6%, p<0.01) and a higher proportion of patients who underwent ureteral rest (84.5% versus 63.0%, p=0.01) in the surgical success group. Multivariate logistic regression analysis (Table 2) further revealed that patients with diabetes were 3.74 times more at risk (p=0.01, CI: 1.35-10.37) of failing to achieve surgical success compared to those without diabetes. Patients undergoing ureteral rest prior to RUR were 2.68 times more likely (p=0.04, CI: 1.05-6.82) to achieve surgical success compared to those who did not undergo ureteral rest. Conclusions: In patients undergoing RUR for management of proximal and middle ureteral strictures, preoperative factors such as the absence of diabetes and the implementation of ureteral rest may optimize surgical outcomes. DP-16 DP-15 52