World J Urol. 2018 Oct 25. doi: 10.1007/s00345-018-2540-z. [Epub ahead of print]

Evaluation of the effect of urethroplasty for anterior urethral strictures by a validated disease-specific patient-reported outcome measure.

Horiguchi A¹, Shinchi M², Ojima K², Masunaga A², Ito K², Asano T², Takahashi E³, Kimura F³, Azuma R⁴.

Author information:
1. Department of Urology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan. impreza@ndmc.ac.jp.
2. Department of Urology, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, 359-8513, Japan.
3. Department of Urology, Nishisaitama-chuo National Hospital, Saitama, Japan.
4. Department of Plastic Surgery, National Defense Medical College, Saitama, Japan.

Abstract

PURPOSE:

To better understand our urethroplasty outcome, we translated the English version of a urethral stricture surgery patient-reported outcome measure (USS-PROM) into Japanese and used it to evaluate the effect of urethroplasty for anterior urethral strictures.

METHODS:

The PROM quantifies lower urinary tract symptoms (LUTS) and health-related quality of life (EQ-5D), and it evaluates overall satisfaction by asking patients to choose «very satisfied», «satisfied», «unsatisfied», or «very unsatisfied». 93 Japanese-speaking male patients with anterior urethral stricture who underwent urethroplasty completed it before (baseline) and 6 months after urethroplasty. The psychometric criteria evaluated in the present study were the PROM’s internal consistency, test-retest reliability, criterion validity, and responsiveness.

RESULTS:

Q_max was negatively correlated with the LUTS-total scores (r = – 0.61). Cronbach’s alpha was 0.80 and the test-retest intraclass correlation coefficient for the LUTS-total score was 0.82. 83 patients (89.2%) achieved stricture-free, which was defined as no re-stricture on cystoscopy and no need for additional treatment. The mean total LUTS-score improved from 12.4 at baseline to 3.7 postoperatively (p < 0.0001). The mean EQ-5D visual analogue scores and EQ-5D index improved from 61.2 and 0.76, respectively, at baseline to 77.9 and 0.89 postoperatively (p < 0.0001, p < 0.0001). 55 patients (59.1%) were «very satisfied» with the outcome of their urethroplasty and 33 (35.5%) were «satisfied».

CONCLUSIONS:

The Japanese version of the USS-PROM has adequate psychometric properties. Urethroplasty improved not only objective data but also voiding symptoms and health-related QOL, and it resulted in a high rate of patient satisfaction.