Reconstructive Urology| Volume 130, P155-161, August 2019

Qualitative Analysis of the Content Found in Online Discussion Boards for Urethral Stricture Disease and Urethroplasty



      To describe the patient experience and chief concerns with urethroplasty to improve physician understanding and patient education. Online discussion boards allow patients with urethral stricture disease (USD) to connect with other USD patients. It is unknown how men use these web resources and what information is available about urethroplasty.


      Three online forums featuring urethroplasty were identified by Google search. Thematic analysis categorized the content of posts using manually applied codes, with inter-rater reliability and descriptive statistics generated by Dedoose (Los Angeles, CA).


      A total of 140 unique posters contributed 553 posts to the forums. Posts were categorized as information support (n = 651), issues posturethroplasty (n = 470), own experience preurethroplasty (n = 336), feelings towards other posters (n = 312), what to expect posturethroplasty (n = 265), feelings after urethroplasty (n = 228), and considerations before urethroplasty (n = 134). Experience navigating the healthcare system with USD (n = 141) and weak urine stream (n = 70) were the most frequent preurethroplasty complaints. Postoperative pain (n = 164) was the most frequent issue. Patients expressed more positivity (n = 126) and satisfaction (n = 120) than negativity (n = 33) with urethroplasty.


      Patients participated in online discussions to share experiences with USD and urethroplasty, receive emotional support, and find answers. Men were more often satisfied than not with their urethroplasty outcomes, with 88% of postoperative feelings coded as positive or satisfied compared to negative. This study provides physicians with insight into the experiences of patients and how to best educate them.
      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 to Urology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Goodwin P.J.
        Support groups in advanced breast cancer: living better if not longer.
        Cancer Interdiscip Int J Am Cancer Soc. 2005; 104: 2596-2601
        • Fox S.
        • Duggan M.
        [W6] Health online 2013.
        Health (Irvine Calif). 2013; (doi: 2013/01/15/health-online-2013/): 1-55
        • Barry M.J.
        • Edgman-Levitan S.
        Shared decision making–the pinnacle of patient-centered care.
        N Engl J Med. 2012; 366: 780-781
        • Rice P.L.
        • Douglas E.
        Sampling strategies for qualitative research.
        Qual Res Meth. 1999;
        • Nuss G.R.
        • Granieri M.A.
        • Zhao L.C.
        • Thum D.J.
        • Gonzalez C.M.
        Presenting symptoms of anterior urethral stricture disease: a disease specific, patient reported questionnaire to measure outcomes.
        J Urol. 2012;
        • Grosberg D.
        • Grinvald H.
        • Reuveni H.
        • Magnezi R.
        Frequent surfing on social health networks is associated with increased knowledge and patient health activation.
        J Med Internet Res. 2016;
        • Santucci R.A.
        • Joyce G.F.
        • Wise M.
        Male urethral stricture disease.
        J Urol. 2007;
        • Breyer B.N.
        • Edwards T.C.
        • Patrick D.L.
        • Voelzke B.B.
        Comprehensive qualitative assessment of urethral stricture disease: toward the development of a patient centered outcome measure.
        J Urol. 2017;
        • Kirkman J.J.L.
        • Leo B.
        • Moore J.C.
        Alcohol consumption reduction among a web-based supportive community using the hello sunday morning blog platform: observational study.
        J Med Internet Res. 2018;
        • Tanaka R.
        • Banerjee A.
        • Surikova J.
        • et al.
        A moderated e-forum for adults with cardiovascular disease: usability study.
        J Med Internet Res. 2018;
        • Cole J.
        • Watkins C.
        • Kleine D.
        Health advice from internet discussion forums: how bad is dangerous?.
        J Med Internet Res. 2016;
        • Evans P.
        • Keihani S.
        • Breyer B.N.
        • et al.
        A prospective study of patient-reported pain after bulbar urethroplasty.
        Urology. 2018;
        • Bertrand L.A.
        • Warren G.J.
        • Voelzke B.B.
        • et al.
        Lower urinary tract pain and anterior urethral stricture disease: prevalence and effects of urethral reconstruction.
        J Urol. 2015;
        • Dublin N.
        • Stewart L.H.
        Oral complications after buccal mucosal graft harvest for urethroplasty.
        BJU Int. 2004;
        • Patel D.P.
        • Elliott S.P.
        • Voelzke B.B.
        • et al.
        Patient-reported sexual function after staged penile urethroplasty.
        Urology. 2015;
        • Dogra P.N.
        • Singh P.
        • Nayyar R.
        • Yadav S.
        Sexual Dysfunction after urethroplasty.
        Urol Clin North Am. 2017;
        • Maciejewski C.C.
        • Haines T.
        • Rourke K.F.
        Chordee and penile shortening rather than voiding function are associated with patient dissatisfaction after urethroplasty.
        Urology. 2017;
        • Jackson M.J.
        • Chaudhury I.
        • Mangera A.
        • et al.
        A prospective patient-centred evaluation of urethroplasty for anterior urethral stricture using a validated patient-reported outcome measure.
        Eur Urol. 2013;
        • Hampson L.A.
        • Lin T.K.
        • Wilson L.
        • Allen I.E.
        • Gaither T.W.
        • Breyer B.N.
        Understanding patients’ preferences for surgical management of urethral stricture disease.
        World J Urol. 2017;
        • Delong J.
        • Buckley J.
        Patient-reported outcomes combined with objective data to evaluate outcomes after urethral reconstruction.
        Urology. 2013;