Mp56-13 patient-Perceived Changes in Penile Appearance Post-Urethroplasty

Abstract

INTRODUCTION AND OBJECTIVE: Alterations in penile curvature or length post-urethroplasty are associated with patient dissatisfaction but are poorly described. This study aims to define the incidence and associations of patient-reported penile curvature and shortening after urethroplasty.METHODS: From 2011-2018, 387 patients completed enrollment in a prospective single-centre study assessing patient-reported outcomes pre-operatively and 6-months post-urethroplasty. Primary outcomes of perceived penile shortening and curvature were assessed at 6-months follow-up. Descriptive statistics were used to summarize findings while univariate and multivariate binary logistic regression was used to identify associations between loss of penile length or chordee with other clinical factors.RESULTS: Of the 387 patients, mean age was 49.5 years with mean stricture length of 4.5 cm. Postoperatively, 12.7% of patients perceived penile curvature (8.0% "somewhat", 4.7% "severe") and 22.8% of patients perceived penile shortening (14.5% "somewhat", 8.3% "a lot"). Multivariate binary logistic regression identified stricture location (p[0.02) to be associated with perceived curvature while prior urethroplasty (p[0.17), type of urethroplasty (p[0.08) and other factors were not. Specifically, penile (O.R. 4.27, 95% CI 1.56-11.68, p[0.005) and panurethral (O.R. 10.15, 95% CI 3.46-29.77, p<0.001) locations were independently associated with this outcome. In a multivariate model, panurethral strictures (O.R. 4.23, 95% CI 1.10-16.20, p[0.04) and hypospadias (O.R. 5.46, 95% CI 1.32-22.70, p[0.02) were associated with patient perceived shortening while other factors such as age (p[0.19), type of urethroplasty (p[0.14) and other stricture etiologies or locations were not.CONCLUSIONS: Clinically significant changes in penile appearance are more common post-urethroplasty than initially thought. Stricture location and etiology are important predictors of these patientperceived changes.