Assessment of Satisfaction and Quality of Life using Patient-reported Outcome Measures after Perineal Urethrostomy: A Prospective Analysis

ABSTRACT

Introduction: Conventionally, success after urethroplasty has focused on objective measures such as urinary flow rates, postvoid residual (PVR) volumes, and appearance of the urethra on cystoscopy and/or retrograde urethrogram. The objective ofthis study was to prospectively analyze the pre- and post-operative patient-reported outcome measures describing patients’satisfaction and quality of life (QoL) after perineal urethrostomy and to compare these results with objective data.Materials and Methods: We prospectively collected data from 30 consecutive patients who underwent perineal urethrostomyfor complex anterior urethral stricture from April 2017 to January 2019. Patient demographics, International Prostate SymptomScore (IPSS), QoL score, urethral stricture surgery patient-reported outcome measure (USS-PROM), maximum flow rate, andPVR urine were collected before, and 2 and 8 months after surgery. General estimation equation was used to compare theresults and linear regression analysis to correlate both questionnaires with objective data.Results: Mean age was 63 years. All patients had undergone previous urethral surgery in the form of multiple DVIU, urethraldilatation, substitution, or augmentation urethroplasties. The mean USS-PROM score improved from 13.4 preoperatively to 3.10after surgery (P < 0.001) and 85.6% of patients were satisfied or very satisfied with surgical results. Strong negative correlationwas found, respectively, between flow rate and USS-PROM and with IPSS.Conclusion: Significant improvements in urinary symptoms and in QoL are expected after perineal urethrostomy for complexanterior urethral stricture and they are correlated with objective measures.