To compare the utility of generic health quality of life (QOL) and condition specific indicators as patient reported outcomes measures for urethral stricture surgery.
Materials and Methods
Patient data were obtained from the Trauma and Urologic Reconstructive Network of Surgeons collaborative database. Patients who underwent any successful urethroplasty and completed both pre- and postoperative generic and condition-specific questionnaires were included.
A total of 201 patients met inclusion criteria. Urethral-stricture specific measures improved after surgery: mean LUTS score (13.1-4.0, p<0.05), Peeling curve (3.1-1.7, p < 0.05), and overall interference of urinary symptoms on life (3.0-1.6, p < 0.05). Mean overall health status visual analog scale (74.2-80.0, p < 0.05) and generic health QOL EQ-5D index scores (0.90-0.95, p < 0.05) also improved; however, individual EQ-5D measures assessing mobility, self-care, and activity level did not change. EQ-5D measures for pain/discomfort (1.48-1.23, p < 0.05) and anxiety/depression (1.33-1.21, p < 0.05) improved, but not to the same extent as stricture-specific measures. More patients reported improvement in condition-specific urethra/penis pain and bladder pain compared to improvement in generic EQ-5D pain/discomfort (p < 0.001).
Generic health QOL indicators are less meaningful in the assessment of urethral stricture surgery and should be replaced with condition-specific outcomes measures. It is important to ensure that appropriate condition-specific outcomes measures are utilized as patient reported outcomes measures become more prevalent in medicine and potentially become utilized to evaluate surgeon outcomes and determine surgeon reimbursement.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Urology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Stricture recurrence after urethroplasty: a systematic review.J Urol. 2009; 182: 1266-1270
- Measuring and predicting patient dissatisfaction after anterior urethroplasty using patient reported outcomes measures.J Urol. 2016; 196: 453-461
- Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction.Int J Impot Res. 1999; 11: 319-326
- Male Sexual Health Questionnaire (MSHQ): scale development and psychometric validation.Urology. 2004; 64: 777-782
- Defining a patient-reported outcome measure for urethral stricture surgery.Eur Urol. 2011; 60: 60-68
- Development and preliminary testing of the new five-level version of EQ-5D (EQ-5D-5L).Qual Life Res. 2011; 20: 1727-1736
- A prospective patient-centred evaluation of urethroplasty for anterior urethral stricture using a validated patient-reported outcome measure.Eur Urol. 2013; 64: 777-782
- Diagnostic assessment of benign prostatic hyperplasia.Prostate Suppl. 1989; 2: 51-68
- The values and value of patient-centered care.Ann Fam Med. 2011; 9: 100-103
- Quality criteria were proposed for measurement properties of health status questionnaires.J Clin Epidemiol. 2007; 60: 34-42
- Patient-Reported Outcome Measures in Urethral Reconstruction.Curr Urol Rep. 2018; 19: 48
- The American Urological Association symptom score in the evaluation of men with lower urinary tract symptoms: at 2 years of followup, does it work?.J Urol. 1996; 155: 1971-1974
- Prospective evaluation of the American Urological Association symptom index and peak urinary flow rate for the followup of men with known urethral stricture disease.J Urol. 2002; 168: 2051-2054
- American Urological Association symptom index in the assessment of urethroplasty outcomes.J Urol. 1998; 159: 1192-1194
- Presenting symptoms of anterior urethral stricture disease: a disease specific, patient reported questionnaire to measure outcomes.J Urol. 2012; 187: 559-562
- The International Prostate Symptom Score (IPSS) is an inadequate tool to screen for urethral stricture recurrence after anterior urethroplasty.Urology. 2016; 95: 197-201
- Patient satisfaction with the outcome of surgery for urethral stricture.J Urol. 2002; 167: 2507-2511
- Comprehensive qualitative assessment of urethral stricture disease: toward the development of a patient centered outcome measure.J Urol. 2017; 198: 1113-1118
Published online: December 20, 2018
Accepted: December 11, 2018
Received: November 15, 2018
Funding Support: None.
© 2018 Elsevier Inc. All rights reserved.