University of Michigan, Department of Urology, Ann Arbor, Michigan 48109-0330, USA.
Urology. 2011 Jul;78(1):198-201. doi: 10.1016/j.urology.2011.01.045. Epub 2011 Mar 31.
To determine the effect of urethroplasty for urethral stricture disease on both voiding symptoms and sexual function through the use of validated patient questionnaires.
Pre- and post-operative scores for the American Urological Association Symptom Index (AUASI), Incontinence Symptom Index (ISI), and Sexual Health Inventory for Men (SHIM) were obtained and compared for adult male patients undergoing urethroplasty. Score differences were then stratified by age. Relevant clinical and demographic characteristics were also examined.
Over the 15-year study period, 183 patients underwent 222 urethroplasties. Median age at the time of surgery was 45 years. Urethroplasties were performed for 207 anterior and 15 posterior urethral strictures. The most common approaches were primary anastomotic (36.5%), staged (23.9%), and buccal graft augmented (21.6%). Overall, 63% of men had a clinically meaningful (≥4 point) improvement in AUASI total score and 69% had improvement in their quality of life (QOL) score after urethroplasty. In aggregate, AUASI total scores improved by 7 points (P<.001), and QOL scores improved by 2 points (P<.001). There was no significant difference in ISI or SHIM scores before and after urethroplasty. AUASI total scores improved more dramatically in younger patients. Half of patients with improved AUASI QOL scores did not have a corollary improvement in their total score.
As measured by validated questionnaires, patients of all ages can expect a meaningful improvement in bothersome voiding symptoms after urethroplasty for urethral stricture disease, with minimal impact on continence or erectile function.
通过使用经过验证的患者问卷，确定尿道狭窄疾病的尿道成形术对排尿症状和性功能的影响。
对接受尿道成形术的成年男性患者的美国泌尿外科学会症状指数 (AUASI)、尿失禁症状指数 (ISI) 和男性健康问卷 (SHIM) 的术前和术后评分进行了比较。然后根据年龄对评分差异进行分层。还检查了相关的临床和人口统计学特征。
在 15 年的研究期间，183 名患者接受了 222 次尿道成形术。手术时的中位年龄为 45 岁。尿道成形术用于治疗 207 例前尿道和 15 例后尿道狭窄。最常见的方法是原发性吻合术 (36.5%)、分期术 (23.9%) 和颊黏膜移植物增强术 (21.6%)。总体而言，63%的男性 AUASI 总分有临床意义的 (≥4 分) 改善，69%的男性生活质量 (QOL) 评分在尿道成形术后有所改善。AUASI 总分平均提高了 7 分 (P<.001)，QOL 评分提高了 2 分 (P<.001)。尿道成形术后 ISI 或 SHIM 评分无显著差异。AUASI 总分在年轻患者中改善更为明显。一半 AUASI QOL 评分改善的患者总评分没有相应改善。
通过验证问卷测量，所有年龄段的患者都可以期待尿道狭窄疾病的尿道成形术后排尿症状得到有意义的改善，对控尿或勃起功能的影响最小。
