Prospective Evaluation of Patient Reported Outcome Measures After Urethroplasty
Supervisor / Principle Investigator:
MD Class of 2021
Introduction: Urethral Stricture is a narrowing of the urethral lumen causing a broad spectrum of associated signs and symptoms. Urethroplasty is considered the most effective treatment for urethral stricture.
Objective: To better define patient reported outcome measures (PROMs) after urethroplasty as currently most outcomes are surgeon reported.
Methods: 357 patients from 2011-2018 at the University of Alberta Hospital were enrolled in a prospective study assessing PROMs after urethroplasty including satisfaction, urinary function, quality of life, erectile function, ejaculatory function, penile appearance/curvature, genitourinary pain, and post-void dribbling. All outcome measures were assessed with either standardized or literature derived scales.
Results: Of 357 patients, mean age was 49.7 years with a mean stricture length of 4.4cm. Patients had varying stricture location, etiology and urethroplasty techniques. 85.2% of patients failed prior endoscopic treatment and 21.8% had prior urethroplasty. 92.0% of patients were stricture free on follow-up cystoscopy. 80.0% of patients reported being satisfied with the results of surgery while 7.3% of patients were unsatisfied. Voiding function including urinary quality of life, International Prostate Symptom Score (IPSS), post-void dribbling and sitting to void; as well as genitourinary pain improved following urethroplasty. Overall erectile function and the incidence of ejaculatory dysfunction remained unchanged but 12.0% of patients reported new erectile dysfunction and 7.1% reported worsening ejaculatory function. Most patients reported minimal change in penile length or curvature but 6.7% and 3.1% of patients complained of bothersome loss of penile length or curvature.
Conclusion: This study provides a springboard to further examine which factors influence patient satisfaction and quality of life after urethroplasty.