MP60-08 FURTHER DEFINING WHICH OUTCOMES ARE ASSOCIATED WITH PATIENT SATISFACTION AFTER URETHROPLASTY

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) II (MP60)1 Apr 2020MP60-08 FURTHER DEFINING WHICH OUTCOMES ARE ASSOCIATED WITH PATIENT SATISFACTION AFTER URETHROPLASTY Jordan Bekkema* and Keith Rourke Jordan Bekkema*Jordan Bekkema* More articles by this author and Keith RourkeKeith Rourke More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000929.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Outcomes after urethroplasty can be assessed by multiple measures both surgeon-reported and patient-reported. Our objective is to determine which clinical outcomes are associated with patient satisfaction after urethroplasty. METHODS: From 2012-2018, 387 patients enrolled in this prospective single-center study. Patient reported outcomes were assessed preoperatively and 6 months postoperatively including patient satisfaction, voiding function, erectile function, ejaculatory function, penile curvature/appearance, genitourinary pain, post-void dribbling, and standing voiding function. Voiding function was assessed with the IPSS, erectile function was assessed with the IIEF-5 and ejaculatory function was scored with a hybrid of the brief sexual function inventory. The remaining measures were assessed using literature derived 3 or 5 point Likert scales. Urethroplasty success was defined as the easy passage of a 16Fr flexible cystoscope. Descriptive statistics were used to summarize findings while multivariate binary logistic regression was used to determine the association between outcomes and patient satisfaction. RESULTS: Of the 387 patients, mean age was 49.5 years with a mean stricture length of 4.5cm. Urethroplasty techniques included buccal mucosa graft onlay (51.7%), anastomotic (30.7%) or staged (12.1%) reconstruction. At 6-months follow-up 96.1% of patients were stricture free on cystoscopy while 81.7% reported being satisfied. On multivariate binary logistic regression, improvement in IPSS (O.R. 1.1, 95% CI 1.1-1.2, p=0.04), de novo erectile dysfunction (O.R. 0.5, 95% CI 0.2-0.9, p=0.04), de novo penile curvature (O.R. 0.4, 95% CI 0.2-0.9, p=0.03) and improved standing voiding function (O.R. 1.3, 95% CI 1.1-1.5, p=0.004) were associated with patient satisfaction. However, cystoscopic success (p=0.60), change in pain score (p=0.14), post-void dribbling (p=0.69), change in penile length (p=0.44), and ejaculatory dysfunction were not (p=0.51). CONCLUSIONS: Improved voiding function, patient reported penile curvature, de novo erectile dysfunction and improved standing voiding function are independently associated with patient satisfaction after urethroplasty and should likely be incorporated into any patient centered approach to urethral stricture. While perhaps important to surgeons, cystoscopic success is not associated with patient satisfaction. Source of Funding: Dr. Rex Boake Studentship in Urology © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e892-e892 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jordan Bekkema* More articles by this author Keith Rourke More articles by this author Expand All Advertisement PDF downloadLoading ...