Patient-reported Outcomes Combined With Objective Data to Evaluate Outcomes After Urethral Reconstruction
Patient-reported Outcomes Combined With Objective Data to Evaluate Outcomes After Urethral Reconstruction
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DOI：
10.1016/j.urology.2012.10.046
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发表时间：
2013-02-01
期刊：
影响因子：
2.1
通讯作者：
Buckley, Jill
中科院分区：
文献类型：
--
作者：
DeLong, Jessica;Buckley, Jill
目的通过比较术前和术后症状问卷的结果，报告患者对尿道重建结果的看法，并提出一种标准化的随访方法。包括患者满意度问卷调查和客观膀胱镜评价，以便于比较不同的尿道重建技术和外科医生和机构之间的结果。接受尿道重建的患者。术前和术后收集患者人口统计学资料、美国泌尿外科协会症状评分、生活质量评分、国际勃起功能指数评分、尿流率和排尿后残余尿量。在术后3个月和6个月对患者进行评价，然后每年进行一次。术后6个月进行软性膀胱镜检查（17 F）。使用Wilcoxon符号秩检验和Mann-Whitney U检验比较检验前和检验后的分布。结果患者平均年龄为47岁，狭窄长度平均为4.9cm。其中吻合尿道成形术32例（29%），覆盖尿道成形术60例（55%），分期尿道成形术7例（6%），筋膜皮瓣尿道成形术11例（10%）。比较术前和术后数据的中位个体变化是美国泌尿外科协会症状评分改善11分（P < .0001），生活质量评分改善4分（P < .0001），国际勃起功能指数改善0分（P = .05）。没有统一的个人后续调查问卷或流量related与recurrent.CONCLUSION接受尿道重建的患者报告显着改善泌尿困扰和生活质量评分，同时保持或改善勃起功能。膀胱镜评价是术后随访算法的一个有价值的组成部分，提供了一致的数据点进行比较，并确认修复的通畅性。测量结果的标准化对于验证报告的尿道重建结果至关重要。泌尿学81：432-436，2013年。(C)2013 Elsevier Inc.
OBJECTIVE To report patients' perceptions of urethral reconstruction outcomes by comparing the results from preoperative and postoperative symptom questionnaires and to propose a standardized method of follow-up that includes patient satisfaction questionnaires and objective cystoscopic evaluation to facilitate comparison of different urethral reconstructive techniques and outcomes among surgeons and institutions.MATERIALS AND METHODS Data were prospectively collected for 110 consecutive patients undergoing urethral reconstruction. Patient demographics, American Urological Association Symptom Score, quality of life score, International Index of Erectile Function score, flow rate, and postvoid residual urine volume were collected pre- and postoperatively. The patients were evaluated at 3 and 6 months postoperatively and then yearly. Flexible cystoscopy (17F) was performed at 6 months postoperatively. The Wilcoxon signed rank test and Mann-Whitney U test were used to compare the pre- and post-test distributions. One-way analysis of variance was used to compare the mean values among groups.RESULTS The mean patient age was 47 years, and the mean stricture length was 4.9 cm. Of the 110 patients, 32 received anastomotic (29%), 60 onlay (55%), 7 staged (6%), and 11 fasciocutaneous flap (10%) urethroplasty. The median individual change comparing the pre- and postoperative data was an improvement of 11 for the American Urological Association Symptom Score (P < .0001), 4 for the quality of life score (P < .0001), and 0 for International Index of Erectile Function (P = .05). No unifying individual follow-up questionnaire or flow rate correlated with recurrence.CONCLUSION Patients undergoing urethral reconstruction reported significant improvement in urinary bother and quality of life scores while maintaining or improving their erectile function. Cystoscopic evaluation can be a valuable component of the postoperative follow-up algorithm, providing a consistent data point for comparison and confirming the patency of repair. Standardization of the measured outcomes is critical to validate the reported urethral reconstructive outcomes. UROLOGY 81: 432-436, 2013. (C) 2013 Elsevier Inc.