Journal of Urological Surgery (Jun 2022)

Evaluation of Functional, Objective and Sexual Outcomes and Patient Reported Quality of Life After Anterior Urethral Reconstruction

  • Sabby Dias,
  • Vijay Patidar,
  • Rohit Namdev,
  • Sandeep Kumar,
  • Shivanand Prakash,
  • Hari Shankar,
  • Sameer Trivedi

DOI
https://doi.org/10.4274/jus.galenos.2022.2021.0081
Journal volume & issue
Vol. 9, no. 2
pp. 90 – 97

Abstract

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Objective:To assess patient satisfaction and quality of life after urethroplasty using clinician driven and patient reported outcome measures.Materials and Methods:We prospectively evaluated fifty-one men with anterior urethral stricture who underwent urethroplasty. Patient demographics, maximum flow rate and post-void residual urine, International Prostate Symptom Score (IPSS), urethral stricture surgery patient-reported outcome measure (USS-PROM), five-item International Index of Erectile Function (IIEF-5), Male Sexual Health Questionnaire Short Form (MSHQ EjD SF), were collected before surgery and compared with outcomes 1 year after surgery.Results:Fifty-one men with anterior urethral stricture underwent 18 (35.3%) anastomotic urethroplasties and 33 (64.7%) augmentation urethroplasties. Of 47 men who were available at follow-up, Qmax improved from preoperative mean of 4.4 to 18.3 [-13.86; 95% confidence interval (CI) (-15.1) - (-12.6); p<0.001], post-void residual urine volume (PVR) from 115.1 to 22.1 (93.0; 95% CI 75.2 - 111; p<0.001), IPSS from 20.93 to 3.55 (17.3; 95% CI 16.1 - 18.6; p<0.001). 38 (80.9%) patients were “very satisfied”, 3 (6.4%) patients were “satisfied”, 5 (10.6%) patients were “unsatisfied” and 1 (2.1%) patient was “very unsatisfied” with the surgery as per USS-PROM. IIEF-5 was insignificantly improved from preoperative mean of 20.72 to 20.89 [-0.17; 95% CI (-0.6) - 0.3; p=0.47] and MSHQ-EjD SF was significantly improved from 10.2 to 11.2 [-0.1; 95% CI (-1.2) - (-0.7); p<0.001].Conclusion:Patient-reported outcome measurements play an important role in evaluating the outcome of urethroplasty in men with urethral stricture disease and should be used concomitantly with objective measurements of Qmax and PVR. This helps in evaluating the outcomes of surgery in the form of patient satisfaction and quality of life.

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