‘Comparison of Patient Reported Outcome Measures for Direct Visual Internal Urethrotomy and Non-Transecting Urethroplasty for Short Bulbar Stricture’

Abstract

Background:To evaluate the functional and sexual outcomes of Primary DVIU and Non- transecting bulbar urethroplasty (NTA) for short segment (<2 cm) bulbar urethral strictures using the Modified USS PROM.Methods:The USS PROM questionnaire comprising of a six-item LUTS domain, a LUTS-specific QOL question, and a peeling’s voiding picture score was used. To achieve a holistic approach to the evaluation of stricture surgery outcomes a six-item IIEF and four-item version of MSHQ-EjD domains, completed the questionnaires. All cases of short bulbar urethral stricture who underwent primary DVIU and NTA between September 2018 and September 2019 and consented to filling out the questionnaires were enrolled into the study. Results:The LUTS score for the NTA at 12 months is significantly better (1.93 ± 2.13 Vs 8.76 ± 5.92, p=0.000). The Peeling score of the NTA is significant better at 6 months (1.59 ± 0.56 Vs 2.26 ± 0.96, p=0.000) and 12 months (1.41 ± 0.68 Vs 2.67 ± 0.73, p=0.000). Erectile function score at 12 months for NTA is significantly better than DVIU (24.37 ± 3.2 Vs 21.143 ± 2.86, p=0.001). The Ejaculatory function score at 6 months is significantly better for the NTA. Finally the Uroflowmetry (Qmax) is significant in NTA group at 12 months (26.7 ± 4.08 Vs 15.35 ± 5.16, p =0.000).Conclusion:NTA shows superior outcomes in almost all domains of USS- PROM, both in terms of voiding and sexual function. This should be the preferred first choice treatment for short segment bulbar stricture.Trail Registration- CTRI /2020/02/023578