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

Abstract

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.