Maciejewski Conrad C, Haines Trevor, Rourke Keith F
Division of Urology, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada.
Division of Urology, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.
Urology. 2017 May;103:234-239. doi: 10.1016/j.urology.2016.12.047. Epub 2017 Jan 5.
To identify factors that predict patient satisfaction after urethroplasty by prospectively examining patient-reported quality of life scores using 3 validated instruments.
A 3-part prospective survey consisting of the International Prostate Symptom Score (IPSS), the International Index of Erectile Function (IIEF) score, and a urethroplasty quality of life survey was completed by patients who underwent urethroplasty preoperatively and at 6 months postoperatively. The quality of life score included questions on genitourinary pain, urinary tract infection (UTI), postvoid dribbling, chordee, shortening, overall satisfaction, and overall health. Data were analyzed using descriptive statistics, paired t test, univariate and multivariate logistic regression analyses, and Wilcoxon signed-rank analysis.
Patients were enrolled in the study from February 2011 to December 2014, and a total of 94 patients who underwent a total of 102 urethroplasties completed the study. Patients reported statistically significant improvements in IPSS (P < .001). Ordinal linear regression analysis revealed no association between age, IPSS, or IIEF score and patient satisfaction. Wilcoxon signed-rank analysis revealed significant improvements in pain scores (P = .02), UTI (P < .001), perceived overall health (P = .01), and satisfaction (P < .001). Univariate logistic regression identified a length >4 cm and the absence of UTI, pain, shortening, and chordee as predictors of patient satisfaction. Multivariate analysis of quality of life domain scores identified absence of shortening and absence of chordee as independent predictors of patient satisfaction following urethroplasty (P < .01).
Patient voiding function and quality of life improve significantly following urethroplasty, but improvement in voiding function is not associated with patient satisfaction. Chordee status and perceived penile shortening impact patient satisfaction, and should be included in patient-reported outcome measures.
通过前瞻性地使用3种经过验证的工具检查患者报告的生活质量评分，确定预测尿道成形术后患者满意度的因素。
对接受尿道成形术的患者在术前和术后6个月完成一项由三部分组成的前瞻性调查，包括国际前列腺症状评分（IPSS）、国际勃起功能指数（IIEF）评分和尿道成形术生活质量调查。生活质量评分包括有关泌尿生殖系统疼痛、尿路感染（UTI）、排尿后滴沥、阴茎下弯、阴茎缩短、总体满意度和总体健康状况的问题。使用描述性统计、配对t检验、单因素和多因素逻辑回归分析以及Wilcoxon符号秩分析对数据进行分析。
患者于2011年2月至2014年12月纳入本研究，共有94例接受了102次尿道成形术的患者完成了研究。患者报告IPSS有统计学意义的改善（P < .001）。有序线性回归分析显示年龄、IPSS或IIEF评分与患者满意度之间无关联。Wilcoxon符号秩分析显示疼痛评分（P = .02）、UTI（P < .001）、感知总体健康状况（P = .01）和满意度（P < .001）有显著改善。单因素逻辑回归确定长度>4 cm以及无UTI、疼痛、缩短和阴茎下弯是患者满意度的预测因素。生活质量领域评分的多因素分析确定无缩短和无阴茎下弯是尿道成形术后患者满意度的独立预测因素（P < .01）。
尿道成形术后患者排尿功能和生活质量显著改善，但排尿功能的改善与患者满意度无关。阴茎下弯状态和感知阴茎缩短影响患者满意度，应纳入患者报告的结局指标中。
