Login to Access Video or Poster Abstract: MP36-14
Sources of Funding: None

Introduction

Overall health quality of life (QOL) indicators may capture non-urological issues such as back pain or arthritis when used as patient reported outcomes measures (PROM) for urethral stricture surgery. We hypothesize that generic health QOL indicators are not meaningful in the assessment of urethral stricture surgery and should be replaced with stricture-specific measures.

Methods

Patient data was obtained from the Trauma and Urologic Reconstructive Network of Surgeons (TURNS) collaborative database. Patients who underwent a successful urethroplasty, defined by passage of a cystoscope through the repair and no secondary procedure on post-operative evaluation, were included in this study. All patients completed pre- and post-operative questionnaires based on a recently published urethral stricture surgery questionnaire validated in 2013.

Results

Inclusion criteria were met by 201 patients who underwent successful urethroplasty at a mean age of 47 years. Post-operative questionnaires were completed at a mean time of 7.3 months after surgery. Urethral-stricture specific measures improved after surgery: mean LUTS score (13.1 to 4.0, p<0.05), Peelings voiding picture (3.1 to 1.7, p<0.05), and overall interference of urinary symptoms on life (3.0 to 1.6, p<0.05). Mean overall health status visual analog scale (74.2 to 80.0, p<0.05) and EQ-5D index scores (0.90 to 0.95, p<0.05) also improved; however, individual EQ-5D measures assessing mobility, self-care, and activity level did not change. Although individual EQ-5D measures for pain/discomfort (1.48 to 1.23, p<0.05) and anxiety/depression (1.33 to 1.21, p<0.05) improved, these measures did not correlate with a successful urethroplasty to the same extent as stricture-specific measures (Figure). Only 2 of the 11 patients who reported worse overall pain/discomfort also reported worse bladder or urethral/penile pain when asked about urological-specific pain.

Conclusions

Generic health QOL indicators may capture medical issues not related to stricture disease and should be replaced with urethral stricture-specific outcomes measures. As PROMs become more prevalent and utilized to evaluate surgeon outcomes and determine reimbursements, it is important to ensure that appropriate condition-specific measures are assessed.

Funding

None