Patient-reported outcome measures using modified urethral stricture surgery: Patient-reported outcome measure for direct visual internal urethrotomy and nontransecting urethroplasty for short nontraumatic bulbar urethral stricture – A prospective comparative observational study from a university teaching hospital

IF 0.8 Q4 UROLOGY & NEPHROLOGY
Arun Chawla, Mummalaneni Sitaram, SurajJayadeva Reddy, JeanJ M C H de la Rosette, Pilar Laguna, SunilPillai Bhaskara, BathiSourabh Reddy, Shruti Pandit, Anupam Choudhary
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Abstract

Purpose: To evaluate the patient-reported outcomes of primary direct visual internal urethrotomy (DVIU) and nontransecting bulbar urethroplasty techniques (NTBU) for the short segment (<2 cm) nontraumatic bulbar urethral stricture using the modified urethral stricture surgery patient-reported outcome measures (USS PROMs). Materials and Methods: The USS PROM questionnaire used to evaluate lower urinary tract symptom (LUTS) was modified by adding a six-item International Index of Erectile Function and a four-item version of MSHQ-EjD to evaluate erectile and ejaculatory domains. All cases of short nontraumatic bulbar urethral stricture who underwent primary DVIU and NTBU who consented were asked to fill the modified PROM at initial evaluation, at 6 months, and at 1 year. Results: The LUTS score for NTBU at 12 months is significantly better (1.93 ± 2.13 vs. 8.76 ± 5.92, P = 0.000). The Peeling score of the NTBU is significantly better at 12 months (1.41 ± 0.68 vs. 2.67 ± 0.73, P = 0.000). The erectile function score at 12 months for NTBU is better than DVIU (24.37 ± 3.2 vs. 21.143 ± 2.86, P = 0.001). The Ejaculatory function score at 6 months and 12 months is significantly better for the NTBU. Receiver operating characteristic (ROC) AND Odd's Ratio analysis for analyzing patient satisfaction showed erectile function (area under ROC [AUROC] - 0.889, P < 0.001), ejaculatory function (AUROC - 0.957, P < 0.001) at 1 year and maximum flow rate of urine on uroflometry (Qmax) (AUROC - 0.928, P < 0.001) at 6 months and (AUROC - 1.000, P < 0.001) at 1 year. The overall satisfaction rates in patients undergoing NTBU is 96.5%. Conclusion: NTBU shows superior outcomes in almost all domains of USS-PROM with better overall satisfaction rates. Improvement of sexual function domain, followed by the LUTS domain was the best predictor of overall patient satisfaction and improvement in the quality of life at 1 year.
改良尿道狭窄手术患者报告的结果测量:直接目视内尿道切开术和非横切性尿道成形术治疗短期非创伤性球尿道狭窄患者报告的结果测量——一项来自大学教学医院的前瞻性比较观察研究
目的:采用改良尿道狭窄手术患者报告结果测量法(USS PROMs)评价直接目视内尿道切开术(DVIU)和非横断球尿道成形术(NTBU)治疗短段(< 2cm)非外伤性球尿道狭窄的患者报告结果。材料与方法:对用于评估下尿路症状(LUTS)的USS PROM问卷进行修改,加入6项国际勃起功能指数和4项版本的MSHQ-EjD来评估勃起和射精域。所有接受原发性DVIU和nbu治疗的短期非外伤性球尿道狭窄患者均被要求在初始评估、6个月和1年时填充改良的PROM。结果:nbu组12个月时LUTS评分明显优于nbu组(1.93±2.13比8.76±5.92,P = 0.000)。nbu在12个月时的剥皮评分(1.41±0.68比2.67±0.73,P = 0.000)明显优于nbu。nbu组12个月的勃起功能评分优于DVIU组(24.37±3.2比21.143±2.86,P = 0.001)。nbu在6个月和12个月时的射精功能评分明显更好。用于分析患者满意度的受试者工作特征(ROC)和Odd’s Ratio分析显示,1年时勃起功能(ROC下面积[AUROC] - 0.889, P < 0.001)、射精功能(AUROC - 0.957, P < 0.001), 6个月时尿量测定最大尿流量(Qmax) (AUROC - 0.928, P < 0.001), 1年时尿量测定最大尿流量(AUROC - 1.000, P < 0.001)。nbu患者总体满意度为96.5%。结论:nbu在USS-PROM的几乎所有领域都有较好的疗效,总体满意度较高。性功能领域的改善,其次是LUTS领域,是患者总体满意度和1年生活质量改善的最佳预测指标。
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来源期刊
Urological Science
Urological Science UROLOGY & NEPHROLOGY-
CiteScore
1.20
自引率
0.00%
发文量
26
审稿时长
6 weeks
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