REPLY TO THE AUTHORS: Re: Long term outcomes of onestage augmentation anterior urethroplasty: a systematic review and meta-analysis

Abstract

To the editor, We appreciate the editorial comments on our manuscript (1, 2). Unfortunately, the reconstructive urology urethroplasty literature is almost all retrospective and cohort sizes are relatively small. Moreover, only a few papers report interim or long-term follow up success. It is because of the very limitations and weaknesses of the urethroplasty literature that we needed to perform a systematic review and meta- -analysis. We closely followed the PRISMA method here and understand the critique of not utilizing the Newcastle-Ottawa Scale to assess the studies. The main take home of our analysis is that the “85% success rate” that is often quoted preoperatively to patients appears to be a clear over -estimation of the success of augmentation urethroplasty. Despite the inherent limitations of the literature, our manuscript clearly shows that augmentation urethroplasty has a slow and progressive recurrence rate overtime. The longer the follow up the more recurrences are identified. Augmentation urethroplasty demonstrates good success at intermediate follow-up, but with longer follow up it appears that it is not the panacea that it is commonly thought. The authors.