Kluth Luis A, Dahlem Roland, Becker Andreas, Schmid Marianne, Soave Armin, Rosenbaum Clemens, Ludwig Tim A, Christ Natalie, Rink Michael, Reiss Philip, Engel Oliver, Riechardt Silke, Chun Felix K-H, Fisch Margit, Ahyai Sascha A
Department of Urology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
World J Urol. 2016 Mar;34(3):369-75. doi: 10.1007/s00345-015-1610-8. Epub 2015 Jun 7.
To validate a German language version of the patient-reported outcome measurement (PROM) following urethral stricture surgery (USS) in a cohort of men undergoing one-stage buccal mucosa graft urethroplasty (BMGU) for urethral stricture. Furthermore, to explore the responsiveness of erectile function (EF) and urinary incontinence (UI) constructs in the context of this intervention.
The USS-PROM captures voiding symptoms (ICIQ-MLUTS) and health-related quality of life (HRQoL) (EQ-5D). To evaluate EF and UI, the IIEF-5 and ICIQ-UI SF were included. Between March 2012 and April 2013, all patients undergoing BMGU at our institution were prospectively enrolled in this study. Psychometric assessment included internal consistency, test-retest reliability, criterion validity and responsiveness.
Ninety-three men completed the USS-PROM before and 3 months after surgery, with 40 (43 %) also completing the USS-PROM 6 months after surgery to assess reliability. Internal consistency: for the ICIQ-MLUTS, Cronbach's α was 0.83. The test-retest intraclass correlation coefficient was 0.94. There was a negative correlation between change in ICIQ-MLUTS total score and change in Q max (r = -0.40). All values exceeded our predefined thresholds. Significant improvements of voiding symptoms and HRQoL demonstrate responsiveness to change (all p values <0.001). While ICIQ-UI scores did not change (p > 0.05), IIEF-5 scores improved significantly (p = 0.048).
The German language USS-PROM shows similar psychometric properties to the English language version. This instrument can be improved by assessing EF by the use of IIEF-5. Further studies with larger patient cohorts are needed to evaluate the significance of measuring UI in urethroplasty patients.
在一组接受一期颊黏膜移植尿道成形术（BMGU）治疗尿道狭窄的男性患者中，验证尿道狭窄手术后患者报告结局测量（PROM）的德语版本。此外，探讨在此干预背景下勃起功能（EF）和尿失禁（UI）指标的反应性。
尿道狭窄手术患者报告结局测量（USS-PROM）涵盖排尿症状（ICIQ-MLUTS）和健康相关生活质量（HRQoL）（EQ-5D）。为评估EF和UI，纳入了国际勃起功能指数-5（IIEF-5）和国际尿失禁咨询委员会尿失禁问卷简表（ICIQ-UI SF）。2012年3月至2013年4月期间，在我们机构接受BMGU的所有患者均前瞻性纳入本研究。心理测量评估包括内部一致性、重测信度、效标效度和反应性。
93名男性在手术前和术后3个月完成了USS-PROM，其中40名（43%）还在术后6个月完成了USS-PROM以评估信度。内部一致性：对于ICIQ-MLUTS，克朗巴哈系数α为0.83。重测组内相关系数为0.94。ICIQ-MLUTS总分变化与最大尿流率（Q max）变化之间存在负相关（r = -0.40）。所有值均超过我们预先设定的阈值。排尿症状和HRQoL的显著改善表明对变化有反应性（所有p值<0.001）。虽然ICIQ-UI评分未变化（p>0.05），但IIEF-5评分显著改善（p = 0.048）。
德语版USS-PROM显示出与英语版相似的心理测量特性。通过使用IIEF-5评估EF可改进该工具。需要对更大的患者队列进行进一步研究，以评估在尿道成形术患者中测量UI的意义。
