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

• Published in: Journal of urological surgery Vol. 9; no. 2; pp. 90 - 97
• Main Authors: Dias, Sabby, Patidar, Vijay, Namdev, Rohit, Kumar, Sandeep, Prakash, Shivanand, Shankar, Hari, Trivedi, Sameer
• Format: Journal Article
• Language: English
• Published: Galenos Yayinevi Tic. Ltd 01.06.2022; Galenos Yayinevi
• Subjects: Complications and side effects; Evaluation; Health aspects; Men; Patient outcomes; Patient satisfaction; Quality of life; sexual function; Surgery; Surgery, Plastic; urethral stricture surgery patient-reported outcome measure; urethroplasty; Urinary organs; India
• ISSN: 2148-9580; 2148-9580
• DOI: 10.4274/jus.galenos.2022.2021.0081

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, [Q.sub.max] 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 [Q.sub.max] and PVR. This helps in evaluating the outcomes of surgery in the form of patient satisfaction and quality of life. Keywords: Urethroplasty, urethral stricture surgery patient-reported outcome measure, sexual function