ABSTRACT
Objective
To assess the incidence of genital pain in patients with urethral stricture and examine
the impact of urethroplasty. Genital pain is a common and challenging urological condition
and potentially associated with urethral stricture.
Methods
From 2011-2019, patients were offered enrollment in a prospective single-center study
assessing patient-reported genital pain pre- and 6-months posturethroplasty. Genital
pain was assessed with the question, “Do you experience genital (scrotum or penis)
pain?” answered on a five-point scale [“Never” (1), “Occasionally” (2), “Sometimes”
(3), “Most of the Time” (4) or “All of the Time” (5)]. Responses of 3, 4, or 5 were
considered clinically significant. Wilcoxon signed-rank test was used to compare pre-
and postoperative states and logistic regression was used to evaluate the association
between genital pain and clinical variables.
Results
Of the 387 patients completing enrollment, 36.4% (141/387) reported genital pain preoperatively.
Patients with panurethral stricture reported higher rates (57.1%) of pain (Odds Ratio
2.93, 95%CI 1.32-6.50; P = .008). Posturethroplasty, pain scores improved with an incidence of 14.2% (P < .0001). In patients reporting preoperative pain, 88.7% (125/141) experienced improvement,
8.5% were unchanged and 2.8% reported worsening pain. On logistic regression, patients
with penile strictures (O.R. 0.24, 95%CI 0.06-0.91; P = .04), hypospadias (O.R. 0.14, 95%CI 0.02-0.88; P = .04), and staged reconstruction (O.R. 0.22, 95%CI 0.05-0.90; P = .04) were less likely to report improvement.
Conclusion
Genital pain is common in patients with urethral stricture and improves in the majority
of patients undergoing urethroplasty but less so in patients with penile strictures,
hypospadias and staged reconstruction.
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 accessOne-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 UrologyAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Prevalence and correlates of three types of pelvic pain in a nationally representative sample of Australian men.J Sex Med. 2008; 5 (Epub 2008 Mar 4. PMID:18331265): 1223-1229https://doi.org/10.1111/j.1743-6109.2007.00784.x
- Contemporary management of chronic prostatitis/chronic pelvic pain syndrome.Eur Urol. 2016; 69 (Epub 2015 Sep 26. PMID:26411805): 286-297https://doi.org/10.1016/j.eururo.2015.08.061
- The clinical spectrum of the presenting signs and symptoms of anterior urethral stricture: detailed analysis of a single institutional cohort.Urology. 2012; 79 ([PubMed:22446349]): 1163
- Lower urinary tract pain and anterior urethral stricture disease: prevalence and effects of urethral reconstruction.J Urol. 2015; 193 (Epub 2014 Jul 18. PMID:25046621; PMCID: PMC4307605): 184-189https://doi.org/10.1016/j.juro.2014.07.007
- Chronic urogenital pain in men.Rev Pain. 2008; 2 (PMID:26526127; PMCID: PMC4589937): 25-28https://doi.org/10.1177/204946370800200207
- A prospective study of patient-reported pain after bulbar urethroplasty.Urology. 2018; 117 (Epub 2018 Apr 12. PMID:29656064): 156-162https://doi.org/10.1016/j.urology.2018.02.046
- Pain frequency moderates the relationship between pain catastrophizing and pain.Front Psychol. 2014; 5 (PMID:25646089; PMCID: PMC4297917): 1421https://doi.org/10.3389/fpsyg.2014.01421
- Newly diagnosed bulbar urethral strictures: etiology and outcome of various treatments.J Urol. 1993; 150 (PMID:8411459): 1725-1728https://doi.org/10.1016/s0022-5347(17)35879-2
- Intraprostatic urinary reflux: an aetiological factor in abacterial prostatitis.Br J Urol. 1982; 54: 729-731
- Canadian Urological Association best practice report on chronic scrotal pain.Can Urol Assoc J. 2018; 12 (Epub 2018 Feb 23. PMID:29485040; PMCID: PMC5994986): 161-172https://doi.org/10.5489/cuaj.5238
- Diagnosis and treatment of interstitial cystitis/bladder pain syndrome.J Urol. 2022; 208 (Epub 2022 May 10. PMID:35536143): 34-42https://doi.org/10.1097/JU.0000000000002756
- Comprehensive qualitative assessment of urethral stricture disease: toward the development of a patient centered outcome measure.J Urol. 2017; 198 (Epub 2017 May 27. PMID:28559007): 1113-1118https://doi.org/10.1016/j.juro.2017.05.077
- Stricture recurrence after urethroplasty: a systematic review.J Urol. 2009; 182 (Epub 2009 Aug 14. PMID:19683309): 1266-1270https://doi.org/10.1016/j.juro.2009.06.027
- Defining a patient-reported outcome measure for urethral stricture surgery.Eur Urol. 2011; 60 ([PubMed:21419566]): 60
- Hypospadias and increased risk for psychiatric symptoms in both childhood and adolescence: a literature review.Front Psychiatry. 2022; 13 (PMID:35280162; PMCID: PMC8904899)799335https://doi.org/10.3389/fpsyt.2022.799335
- Physical therapy for chronic scrotal content pain with associated pelvic floor pain on digital rectal exam.Can J Urol. 2016; 23 (PMID:27995849): 8546-8550
- Placebo effects in the pharmacological treatment of uncomplicated benign prostatic hyperplasia. The ALFECH Study Group.Scand J Urol Nephrol. 1996; 30 (PMID:8936626): 373-377https://doi.org/10.3109/00365599609181313
Article info
Publication history
Published online: November 04, 2022
Accepted:
October 9,
2022
Received:
September 6,
2022
Footnotes
Conflict of Interest: None.
Disclosures: None.
Financial disclosure: Northern Alberta Urology Foundation.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
