Urethral reconstruction patients show significantly improved QoL, symptom scores

May 17, 2011

Patient-reported outcomes after urethral reconstruction reflected improvement in symptomatic and quality of life parameters consistent with objective urodynamic changes, data from a single-center clinical study showed.

Patient-reported outcomes after urethral reconstruction reflected improvement in symptomatic and quality of life parameters consistent with objective urodynamic changes, data from a single-center clinical study showed.

A comparison of patients’ pre- and postsurgical responses to validated questionnaires showed a median improvement of 12 points on the AUA Symptom Score (AUASS) and a 4-point improvement in the quality of life (QoL) assessment. Both results were significantly different from baseline values (p

The patient-reported improvement was corroborated by a significant increase in urinary flow rate and a significant decrease from baseline in postvoid residual (PVR) volume. Cystoscopy performed 6 months after surgical repair correlated with changes in subjective and objective outcomes.

All but one patient maintained presurgical erectile function, and some patients improved.

"Patient-reported outcomes after urethral reconstruction showed significant improvement that correlated with functional studies," said first author Jessica DeLong, MD, of the Lahey Clinic in Brookline, MA, who worked on the study with with Jill Buckley, MD. "The results may provide valuable data for patient education and counseling."

The findings came from a retrospective chart review involving 106 consecutive patients who underwent urethral reconstruction for complex strictures. Dr. DeLong said 87 patients had complete data with respect to demographics, type of surgery, AUASS, QoL, erectile function, flow rate, and PVR and formed the basis for the study.

Patients had follow-up visits at 3, 6, and 12 months, and then yearly. Each patient underwent cystoscopy 6 months after reconstructive surgery.

The primary outcomes of interest were AUSS, QoL, erectile function (as determined by the International Index of Erectile Function [IIEF]), flow rate, PVR, and findings on cystoscopy.

In addition to the significant improvement in AUASS and QoL, pre- and postsurgical IIEF assessments showed no overall change from baseline in erectile function. One patient younger than 45 years of age had a significant decline in IIEF score, and two patients older than 45 had significant improvement.

Median flow rate increased 12 cc/mL, and median PVR decreased by 32 cc.