Shibaev A N, Bazaev V V, Pavlova Yu V
Department of Urology, M.F. Vladimirsky MRRCI, Moscow.
Urologiia. 2016 Nov(5):32-36.
Recent trends in the contemporary medicine have shown a growing request for the personalized choice of treatment and evaluation of its results. PROM-USS questionnaire has been designed for patients undergoing surgical correction of anterior urethral strictures to measure the treatment success using patient reported outcomes in numerical terms.
To test the effectiveness of different surgical modalities for anterior urethral strictures using patient reported outcomes.
Ninety men self-completed the PROM-USS questionnaire after surgical treatment of anterior urethral strictures. Mean and median follow-up was 6-132 months and 72 months, respectively. Measures included lower urinary tract symptom score, overall quality of life (QOL) and overall health, and patient satisfaction with treatment.
At the median follow-up of 72 months after surgery for anterior urethral stricture, the survey findings showed LUTS total score 7.4+/-1.2 and urination score on VAS scale 2.3+/-1.1. Sixty-five (72%) of the men believed that residual LUTS did not significantly affect their quality of life. Fifteen (17%) and 10 (11%) patients reported a slight and moderate/strong negative impact of urinary symptoms on their quality of life, respectively. The EQ-5D score of overall health state on VAS was 73+/-4.2 out of 100, the EQ-5D score of the overall quality of life was 0.79+/-0.2. Seventy-eight (86.7%) of 90 men were satisfied (32.2% very satisfied and 54.5% satisfied) with the surgery results, and 12 (13.3%) were dissatisfied. Reasons for dissatisfaction were the emergence of new problems (post-micturition dribbling) with an overall improvement of urinary symptoms (5) and the lack of improvement in urinary symptoms (7). Among patients treated with OIU, 79% were satisfied, which was significantly less than in groups of men who underwent anastomotic urethroplasty - 89% (p<0.05) and substitution urethroplasty using a buccal mucosal grafting - 95% (p<0.05).
The patient-reported outcomes showed that surgery for anterior urethral stricture is highly effective and characterized by a long term patient satisfaction and quality of life.
当代医学的最新趋势表明，对个性化治疗选择及其效果评估的需求日益增长。PROM-USS问卷专为接受前尿道狭窄手术矫正的患者设计，用于以数值形式衡量治疗成功率，即患者报告的结果。
使用患者报告的结果来测试不同手术方式治疗前尿道狭窄的有效性。
90名男性在接受前尿道狭窄手术后自行完成了PROM-USS问卷。平均随访时间和中位随访时间分别为6至132个月和72个月。测量指标包括下尿路症状评分、总体生活质量（QOL）和总体健康状况，以及患者对治疗的满意度。
在前尿道狭窄手术后中位随访72个月时，调查结果显示下尿路症状总评分为7.4±1.2，视觉模拟量表（VAS）排尿评分为2.3±1.1。65名（72%）男性认为残余下尿路症状未对其生活质量产生显著影响。分别有15名（17%）和10名（11%）患者报告尿路症状对其生活质量有轻微和中度/重度负面影响。VAS上总体健康状态的EQ-5D评分为73±4.2（满分100分），总体生活质量的EQ-5D评分为0.79±0.2。90名男性中有78名（86.7%）对手术结果满意（32.2%非常满意，54.5%满意），12名（13.3%）不满意。不满意的原因包括出现新问题（排尿后滴沥）且尿路症状总体改善（5例）以及尿路症状未改善（7例）。在接受尿道内切开术（OIU）治疗的患者中，79%满意，这显著低于接受吻合性尿道成形术的男性组——89%（p<0.05）和使用颊黏膜移植进行替代尿道成形术的男性组——95%（p<0.05）。
患者报告的结果表明，前尿道狭窄手术非常有效，其特点是患者长期满意度高且生活质量良好。
