PD16-01 UNDERSTANDING PATIENT PREFERENCES FOR SURGICAL MANAGEMENT OF URETHRAL STRICTURE DISEASE

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) I1 Apr 2016PD16-01 UNDERSTANDING PATIENT PREFERENCES FOR SURGICAL MANAGEMENT OF URETHRAL STRICTURE DISEASE Lindsay A. Hampson, Tracy Lin, Leslie Wilson, Isabel Allen, Thomas Gaither, and Benjamin N. Breyer Lindsay A. HampsonLindsay A. Hampson More articles by this author , Tracy LinTracy Lin More articles by this author , Leslie WilsonLeslie Wilson More articles by this author , Isabel AllenIsabel Allen More articles by this author , Thomas GaitherThomas Gaither More articles by this author , and Benjamin N. BreyerBenjamin N. Breyer More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1153AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Urethral stricture disease has a substantial impact on quality of life and surgeons must understand how to best counsel patients about treatment options. We identified which treatment attributes are important to men making decisions about urethral stricture surgery and how prioritization of these attributes varies by patient characteristics. METHODS Male patients with urethral stricture disease participated in a choice-based conjoint analysis exercise with 18 treatment scenarios. Demographic, treatment, and symptom data were collected. Mixed effects logistic regression models were used to analyze patients' preferences and conduct subgroup analysis; a p-value of 0.05 was considered significant. RESULTS Participants had significant preferences within all treatment attributes except recovery time, preferring higher success rate, decreased catheter duration, fewer future procedures, open reconstruction, and lower copayment (Fig1). Based on calculated relative attribute preferences, treatment success rate was the most important attribute, followed by copayment, future procedures, duration of catheterization, type of procedure, and, lastly, recovery time (Fig1). In subgroup analysis, older patients had stronger dislike for a 25% success rate and for additional procedures compared to younger patients, while lower income patients had stronger negative preferences towards higher copayments compared to higher income patients. Patients who previously underwent surgical treatment showed no differences in treatment preferences compared to those who had not. CONCLUSIONS Treatment success rate is the most important treatment attribute, suggesting that patients should be strongly counseled about expected success rates of urethroplasty and urethrotomy. Based on subgroup analysis, doing a ′′less invasive′′ urethrotomy for older patients may not be preferable given the lower success rate and higher chance of future procedures. Costs related to care are meaningful to lower income patients, even eclipsing the importance of success rates at high copayment costs. These results can help urologists' improve patient-centered outcomes through better treatment counseling and determination of optimal management based on patients' characteristics. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e394 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Lindsay A. Hampson More articles by this author Tracy Lin More articles by this author Leslie Wilson More articles by this author Isabel Allen More articles by this author Thomas Gaither More articles by this author Benjamin N. Breyer More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...