Assessment of satisfaction and Quality of Life using self - Reported questionnaires after urethroplasty: A prospective analysis

Abstract

Objectives: To assess patient satisfaction and quality of life after urethroplasty using two different self-reported outcome measures and to compare it with objective clinical data. Materials and Methods: We prospectively collected data from 35 consecutive patients who underwent urethroplasty from January 2013 to September 2014. Patient demographics, International Prostate Symptom Score (IPSS), quality of life score, urethral stricture surgery patient-reported outcome measure (USS-PROM), maximum flow rate (Qmax) and post-void residual urine were collected before, two and eight months after surgery. Failure occurred when any postoperative instrumentation was performed. General estimation equation was used to compare the results and linear regression analysis to correlate both questionnaires with objective data. Results: Mean age was 61 years. Urethroplasties were equally divided between anastomotic and buccal mucosa grafts and 19 patients (59.3%) had a previous urethral procedure. Overall success rate was 87.5%. IPSS improved from a mean 19 at baseline to 5.32 at 8 months (p < 0.001). The mean USS-PROM score also improved from 13.21 preoperatively to 3.36 after surgery (p < 0.001) and 84.3% of patients were satisfied or very satisfied with surgical results. Mean Qmax increased from 4.64mL/s to 11mL/s (p < 0.001). Strong negative correlation was found respectively between flow rate and USS-PROM (r=-0.531, p < 0.001) and with IPSS (r=-0.512, p < 0.001). Conclusions: Significant improvements in urinary symptoms and in quality of life are expected after urethroplasty and they are correlated with objective measures.