Baradaran Nima, Hampson Lindsay A, Edwards Todd C, Voelzke Bryan B, Breyer Benjamin N
Department of Urology, University of California - San Francisco, San Francisco, CA, USA.
Department of Health Services, Seattle Quality of Life Group, University of Washington, Seattle, WA, USA.
Curr Urol Rep. 2018 May 17;19(7):48. doi: 10.1007/s11934-018-0797-9.
Treatment of anterior urethral stricture disease (USD) has shifted from endoscopic approaches to urethroplasty with significantly higher success rates among reconstructive urologists. This academic stance has led to a critical evaluation of "success" and developing disease-specific instruments to assess surgical outcomes focusing on patients' satisfaction rather than the historical goal of avoiding secondary procedures.
Many disease non-specific and/or non-validated patient-reported outcome measures (PROMs) have been utilized to evaluate the voiding symptoms and sexual of function of patients after urethroplasty in the literature. Urethral Stricture Surgery PROM (USS PROM) is the first validated, disease-specific PROM for anterior USD which has been designed in 2001. Urethral Stricture Symptoms and Impact Measure (USSIM) is a comprehensive PROM and is currently being validated at multiple institutions. This article reviews the tools used to assess success after urethroplasty and elaborates the need to develop a comprehensive USD-specific PROM.
前尿道狭窄疾病(USD)的治疗已从内镜治疗转向尿道成形术,在重建泌尿外科医生中成功率显著提高。这种学术立场引发了对“成功”的批判性评估,并开发针对疾病的工具来评估手术结果,重点是患者满意度,而非避免二次手术这一历史目标。
文献中已使用许多疾病非特异性和/或未经验证的患者报告结局测量指标(PROM)来评估尿道成形术后患者的排尿症状和性功能。尿道狭窄手术PROM(USS PROM)是2001年设计的首个针对前尿道狭窄疾病且经验证的特异性PROM。尿道狭窄症状与影响测量指标(USSIM)是一项全面的PROM,目前正在多个机构进行验证。本文回顾了用于评估尿道成形术后成功与否的工具,并阐述了开发针对尿道狭窄疾病的全面PROM的必要性。