Assessment of the short-term functional outcome after urethroplasty: a prospective analysis

Abstract

Objectives: To assess the short-term functional outcomes on urinary symptoms, erectile function, urinary continence and patient's satisfaction after urethroplasty. Materials and Methods: A prospective analysis was done in 21 patients who underwent urethroplasty. An assessment of the urinary flow, urinary symptoms (International Prostate Symptome Score <IPSS>), erectile function (International Index of Erectile Function-5 <IIEF-5>) and urinary continence (International Consultation Committee on Incontinence Questionaire male Short Form <ICI-Q-SF>) was done before urethroplasty and 6 weeks and 6 months after urethroplasty. Patients were also asked to score their satisfaction with the urethroplasty after 6 weeks and 6 months. Results: Mean patient's age was 48 years (range: 26-80 years). Mean stricture length was 4.2 cm (range: 1-12 cm). Three patients suffered a stricture recurrence. Mean maximum urinary flow increased from 5.83 mL/s to 24.92 mL/s (p < 0.001). Mean IPSS preoperative, 6 weeks and 6 months postoperative was respectively 15.86, 4.60 and 6.41(p < 0.001). The mean IIEF-5 score preoperative, 6 weeks and 6 months postoperative was respectively 15, 12.13 and 11.62 (not significant). The mean ICI-Q-SF score preoperative, 6 weeks and 6 months postoperative was respectively 10.47, 8.33 (p = 0.04) and 9.47 (p = 0.31). Patient's satisfaction 6 weeks and 6 months postoperative was respectively 17.14/20 and 17.12/20. Conclusions: Urethroplasty leads to a significant improvement in urinary flow and IPSS and urinary continence is tending to improve. Although not significant, erectile function was slightly diminished after urethroplasty. Functional outcome should be assessed when urethroplasty is performed.

Assessment of satisfaction and Quality of Life using self - reported questionnaires after urethroplasty: a prospective analysis

“…Both studies highlight that the differences between the preoperative and postoperative data using the patient as his own control is, perhaps, more important than setting a Qmax cutoff at which all men should be evaluated for stricture recurrence. Differently, our self-reported outcomes represented by the USS-PROM, IPSS and QoL scores were not diminished by the lesser improvement in Qmax and the results were in accordance with the few studies that analyzed these questionnaires pre- and postoperatively (10, 14-16). …”

“…In our study, the mean Qmax improved from 4.64mL/s preoperatively to 11mL/s 8 months after surgery. These improvements in Qmax were more modest when compared with those reported in other series (12, 14). Maybe this occurred because our patients were older (mean age of 61 years), a group where a large number of men have a component of benign prostatic hyperplasia or have a long-standing urethral obstruction with detrusor dysfunction.…”

Sexual (Dys)function after Urethroplasty

“…There are 3 additional prospective studies, presented in Table 3 , involving mixed cohorts of patients undergoing anterior and posterior urethroplasties [ 42 – 44 ]. All used the IIEF-5 as assessment method.…”

Single‐stage preputial skin flap urethroplasty for long‐segment urethral strictures: evaluation and determinants of success

“…Furthermore, the definition of failure or success in these studies is not consistent , but in general the need for further instrumentation or re‐operation is considered as failure by the majority of urologists . Nevertheless, it is possible that a patient may require no dilatation postoperatively but may not be satisfied with the procedure because of resulting complications or, conversely, that dilatation is required but the patient remains satisfied with the procedure . The effects of the procedure on urinary and sexual function or other postoperative complications may also influence patient satisfaction.…”