Objective
To understand the prevalence of chronic perineal pain, activity limitations, and patient
satisfaction after urethroplasty.
Methods
From 2014 to 2016, we prospectively enrolled men undergoing urethroplasty for bulbar
urethral strictures. Patients, before and after surgery, completed questions from
the Core Lower Urinary Tract Symptom Score assessing pain frequency in the bladder
and penis or urethra, as well as nonvalidated questions assessing perineal pain. Overall
satisfaction with their current urinary condition and pain-related activity limitations
at home, work, or during exercise were also measured. Patients with <3 months of follow-up
were excluded. Pre-and postoperative scores were compared using the Wilcoxon signed-rank
test.
Results
Thirty-five men were included in the study. Mean age and body mass index were 44.6
years and 30.9 kg/m2, respectively. Urethroplasties were anastomotic in 24 (69%) and were single-stage
buccal graft substitution in 11 (31%). Median follow-up after surgery was 483 days
(range: 90-810 days). A total of 10 patients (29%) reported worsening perineal pain
intensity after surgery, whereas 8 (23%) reported improvement and 17 (48%) reported
no change. Overall, pain frequency in the bladder, penis or urethra, and perineum
improved. Home and exercise pain-related activity restrictions improved significantly
after surgery. Satisfaction with current urinary condition also improved with 91%
reporting feeling “delighted,” “pleased,” or “mostly satisfied” with their current
condition.
Conclusion
Patients are highly satisfied with their urinary condition after urethroplasty. Pain
frequency in the bladder and the urethra significantly improves after urethroplasty;
however, perineal pain intensity can worsen and become chronic after surgery in some
patients.
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Article info
Publication history
Published online: April 12, 2018
Accepted:
February 17,
2018
Received:
December 29,
2017
Footnotes
Financial Disclosure: Dr. Sorena Keihani's research fellowship is supported in part by a generous reconstructive urology educational grant from Boston Scientific. The remaining authors declare that they have no relevant financial interests.
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
