Quality of life dynamics in men after urethral stricture surgery

Introduction. In modern medical practice, when conducting clinical trials to assess the effectiveness of the treatment, it has long been recognized that the quality of life of a patient is a highly informative indicator of the assessment of health status. Buccal urethroplasty is one of the most effective methods of surgical treatment of urethral stricture disease in men with scleroatrophic lichen.Materials and methods. Twenty-five patients with urethral stricture caused by scleroatrophic lichen aged 17 to 80 years were examined. All patients underwent surgical treatment in the form of buccal urethroplasty. Of these, 21 patients with extended urethral strictures, and 6 patients with recurrent strictures and urethral obliteration. The study of various aspects of the quality of life of patients after buccal urethroplasty included the study of IPSS, QoL, SF-36 and urodynamic parameters 1, 6, and 12 months after surgery, as well as satisfaction with the results of the operation by the patients themselves.Results. When comparing the results of the SF-36 questionnaire, they improved before surgery, the average result was 66.2 ± 0.5 points, 6 months after surgery 94.1 ± 0.6 points. When studying the QoL score scale before surgery, it was 5.5 ± 1.2 points, after 6 months 1.6±1.5 points, the total I-PSS score before surgery was 32.1± 3.4 points and after 6 months 7.3± 2.9 points. When assessing the indicators of the maximum urination rate before surgery was 15.8 ± 1.2 ml/s, and in the long term after 6 months in patients, the average Qmax was 23.7 ± 1.7 ml/s. Prior to surgical treatment, 84.0% of patients with urethral stricture with scleroatrophic lichen had pain during sexual intercourse, discomfort in the urethra in 64.0% of patients. After buccal urethroplasty after six months, the patient’s quality of life improved, pain during sexual intercourse decreased to 8.0%.Conclusion. Replacement of affected urethral tissues with scleroatrophic lichen with buccal flap helps restore adequate urination and improve patient quality of life.

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Multi-stage urethroplasy for anterior urethral strictures: objective parameters of long-term efficacy and patient-reported outcomes

Глухов

Ilyash

Vasilev

et al. 2022

Vestn. Urol.

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Introduction. Multi-stage urethral surgery is used in cases of the most complex urethral strictures. The evaluation of surgical treatment results given by patients is a significant criterion for the efficacy of urethroplasty along with the assessment of urethral patency through instrumental examinations.Objective. To evaluate the long-term efficacy of multistage urethroplasty for complex anterior urethral strictures considering the patients' quality of life and satisfaction with the surgical outcomes.Materials and methods. The study included 73 patients aged 18 – 84 years with anterior urethral strictures who underwent multi-stage urethroplasty in 2010 – 2019. Surgical and functional outcomes of urethroplasty were assessed through general blood and urine tests, physical examination, uroflowmetry, and retrograde urethrography and urethroscopy in case of urinary disorders. Subjective parameters of treatment efficacy were studied using questionnaires: International Prostate Symptom Score (IPSS); Quality of life (QoL); Patient-reported Outcome Measure for Urethral Stricture Surgery (USS-PROM); Patient Global Impression of Improvement (PGI-I).Results. Recurrent urethral stricture was detected in 19 (26,0%) patients with the average follow-up period being 65 months. Independent urination was restored in 71 (97.3%) cases, including repeated interventions. After surgery, there was a significant increase in urinary flow rate parameters (Q max: 8.1 vs 19.1 ml/s, p < 0.0001; Q ave: 5.5 vs 10.7 ml/s; p = 0.0004), decrease in residual urine volume (62.4 vs 18.6 ml, p < 0.0001), decrease in total IPSS score (18.7 vs 5.7 points; p < 0.0001) and QoL index (4.3 vs 1 .8 points, p < 0.0001). A comparative analysis of preoperative and postoperative USS-PROM questionnaire results demonstrated an improvement in indicators assessing LUTS (12.9 vs 3.4 points; p < 0.0001; 3.6 vs 1.7 points; p < 0.0001), and urination-associated quality of life (2.6 vs 0.6 points; p < 0.0001) and overall health (EQ-5D index: 0.73 vs 0.91 points; p = 0.025; EQ-VAS: 68.0 vs 88.1 points, p = 0.004). Fifty-seven (81.4%) men were “very satisfied” or “satisfied” with the treatment outcomes, while nine (12.9%) respondents noted a moderate effect of residual urinary disorders on the quality of life. Significantly higher satisfaction was observed among cystostomy patients and in cases where repeated interventions were unnecessary.Conclusion. Multi-stage urethroplasty for complex anterior urethral strictures achieves efficacy in 97.3% of cases and is accompanied by high levels of quality of life and patient’s satisfaction during long-term follow-up.

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Quality of life dynamics in men after urethral stricture surgery

Cited by 3 publications

References 11 publications

Results of surgical treatment on short-length bulbous urethral strictures

Results of surgical treatment on short-length bulbous urethral strictures

Urethral strictures caused by lichen sclerosus: evaluation of patient quality of life after buccal urethroplasty

Multi-stage urethroplasy for anterior urethral strictures: objective parameters of long-term efficacy and patient-reported outcomes

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