INTRODUCTION AND OBJECTIVES: Patient reported outcome measures (PROMs) are an invaluable resource that allows the patient to communicate about how they feel about their health and wellbeing. As these measures become more integrated into evidencebased medicine and health care delivery, a comprehensive urethral stricture-specific PROM is needed. We present research aimed to develop such a PROM. Cognitive interviews and item prioritization were performed to reduce previously generated items for development of a urethral-specific PROM. The input of clinicians was queried to compare for comparison to patient data.METHODS: We identified potential items during concept elicitation interviews. Six domains were created based on urinary or sexual items (function, impact, symptoms/signs). Two iterative rounds of cognitive interviews were performed among a separate cohort of five and four patients, respectively, to further test patient understanding of these items (n¼33 urinary, n¼5 sexual). Changes were made to the existing items based upon patient feedback. Item prioritization was conducted among a separate cohort of 20 patients who rated degree of bothersomeness from their urethral stricture (very much, somewhat, does not bother). Male reconstructive urologists (n¼22) also rated the items in regards to importance in making treatment decisions.RESULTS: Of the top 15 items that patients rated by bother, urinary issues predominated. There was only one sexual item (slow force of ejaculation). On average, the patient cohort was most bothered by anxiety about being unable to void, post-void dribbling, and trouble aiming their stream. There was only 53% agreement between patients and clinicians in the 15 items they independently rated as of highest importance.CONCLUSIONS: Based upon the patient-driven item prioritization, we plan to create a PROM, test measurement properties, and modify our instrument, as needed, to create a patient-driven urethral stricture-specific PROM. Discord between patients and clinicians highlight the need for a stricture-specific PROM.
In this exploratory analysis, DM duration was not associated with overall LUTS in multivariable models. However, women had a 6% increased risk of severe UUI for each additional year of DM duration. Given an aging population and rising prevalence of DM, more work is needed to understand the mechanisms of DBD.
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