Department of Urology, University of Iowa, Iowa City, Iowa.
Department of Urology, University of Iowa, Iowa City, Iowa.
J Urol. 2018 Oct;200(4):843-847. doi: 10.1016/j.juro.2018.03.134. Epub 2018 Apr 12.
In this study we aimed to define the prevalence of preoperative and postoperative post-micturition incontinence or post-void dribbling after anterior urethroplasty for urethral stricture disease. We also sought to determine risk factors for its presence.
We retrospectively reviewed a prospectively maintained, multi-institutional urethral stricture database to evaluate post-micturition incontinence using a single question from a validated questionnaire, "How often have you had a slight wetting of your pants a few minutes after you had finished urinating and had dressed yourself?" Possible answers were never-0 to all the time-3. The presence of post-micturition incontinence was defined as any answer greater than 0. Comparisons were made to stricture type and location, repair type and patient medical comorbidities.
Preoperative and postoperative post-micturition incontinence questionnaires were completed by 614 and 331 patients, respectively. Patients without complete data available were excluded from study. Preoperative post-micturition incontinence was present in 73% of patients, of whom 44% stated that this symptom was present most of the time. Overall postoperative post-micturition incontinence was present in 40% of patients and again it was not predicted by stricture location or urethroplasty type. Of the 331 patients with followup questionnaires 60% reported improvement, 32% reported no change and 8% reported worsening symptoms. The overall rate of de novo post-micturition incontinence was low at 6.3%.
The prevalence of preoperative post-micturition incontinence is high and likely under reported. In most patients post-micturition incontinence improves after urethroplasty and the prevalence of de novo post-micturition incontinence is low. The presence of post-micturition incontinence was not predicted by stricture length or location, or urethroplasty repair type.
本研究旨在定义尿道狭窄疾病行尿道前板成形术后术前和术后排尿后尿失禁或排尿后滴沥的发生率。我们还试图确定其存在的危险因素。
我们回顾性地评估了一个前瞻性维护的多机构尿道狭窄数据库，使用一个经过验证的问卷中的一个问题来评估排尿后尿失禁，“您在排尿后穿衣时，是否有过几次裤子轻微潮湿？”可能的答案是从不-0 到一直-3。排尿后尿失禁的存在定义为任何大于 0 的答案。将其与狭窄类型和位置、修复类型和患者的合并症进行比较。
分别有 614 名和 331 名患者完成了术前和术后排尿后尿失禁问卷。有不完整数据的患者被排除在研究之外。术前排尿后尿失禁存在于 73%的患者中，其中 44%的患者表示该症状经常发生。总的术后排尿后尿失禁发生率为 40%，且同样无法预测狭窄位置或尿道成形术类型。在有随访问卷的 331 名患者中，60%的患者报告症状改善，32%的患者报告症状无变化，8%的患者报告症状恶化。新发性排尿后尿失禁的总体发生率较低，为 6.3%。
术前排尿后尿失禁的发生率较高，且可能报告不足。在大多数患者中，尿道成形术后排尿后尿失禁会改善，且新发排尿后尿失禁的发生率较低。排尿后尿失禁的存在与狭窄长度或位置、或尿道成形术修复类型无关。
