Urethral strictures caused by lichen sclerosus: evaluation of patient quality of life after buccal urethroplasty

Abstract

Introduction. In modern medical practice, when conducting clinical trials to assess the effectiveness of the treatment, it has long been recognized that the quality of life of a patient is a highly informative indicator of the assessment of health status. Buccal urethroplasty is one of the most effective methods of surgical treatment of urethral stricture disease in men with scleroatrophic lichen.Materials and methods. Twenty-five patients with urethral stricture caused by scleroatrophic lichen aged 17 to 80 years were examined. All patients underwent buccal urethroplasty. Patient quality of life was assessed 1, 6, and 12 months after buccal urethroplasty using the SF-36 Health Status Survey, the International Prostate Symptom Score (IPSS; Quality of Life — QoL) and urodynamic studies. In addition, a survey of patients was conducted on the subject of satisfaction with the results of the operation.Results. The results of the survey reliably indicate the high efficiency of buccal urethroplasty, reflected in the dynamics of physical indicators (62.5 ± 0.7 vs 71.7 ± 0.9 vs 95.5 ± 1.0 vs 97.2 ± 1.1; p < 0.05) and psychological (69.2 ± 1.1 vs 77.0 ± 0.7 vs 92.2 ± 0.8 vs 96.2 ± 1.0; p < 0.05) well-being according to the SF- 36, IPSS total score (32.1±3.4 vs 15.0±2.7 vs 7.3±2.9 vs 6.8±2.4; p < 0.05) and QoL index (5.5 ± 1.2 vs 3.8 ± 1.7 vs 1.6 ± 1.5 vs 1.4 ± 1.4, p < 0.05). The maximum urine flow rate increased to 19.5 ± 1.2 ml/s one month after surgery, to 23.7 ± 1.7 ml/s after six months, and to 25.8 ± 1.3 ml/s after 12 months, compared to preoperative values of 15.8 ± 1.2 ml/s (p < 0.05).Conclusion. Replacement of affected urethral tissues with scleroatrophic lichen with buccal flap helps restore adequate urination and improve patient quality of life.

Keywords

• urethral strictures
• scleroatrophic lichen
• urethroplasty
• urethral surgery
• buccal graft
• quality of life