Kałużny Adam, Krukowski Jakub, Frankiewicz Mikołaj, Matuszewski Marcin
Medical University of Gdańsk, Department of Urology, Gdańsk, Poland.
Cent European J Urol. 2021;74(1):116-120. doi: 10.5173/ceju.2021.0306.R1. Epub 2021 Jan 15.
The aim of this article was to assess the influence of sexual disorders after urethroplasty on patient's quality of life (QoL) and satisfaction of treatment.
We studied 106 sexually active patients who underwent urethroplasty due to urethral stricture. Patients completed the Urethral Stricture Surgery - Patient Reported Outcome Measure (USS - PROM) and International Index of Erectile Function (IIEF-5) questionnaires before and after the treatment. Spearman rank correlations were used for correlation analyses. Multiple linear regression and ordinal logistic regression analyses were used for evaluating the influence of lower urinary tract symptoms (LUTS) and IIEF-5 scores on EuroQol-5D (EQ-5D) index, EuroQol-Visual Analogue Scale (EQ-VAS), and satisfaction with treatment. Both LUTS and IIEF-5 scores were independent, significant predictors of EQ-VAS in the multiple linear regression model.
Mean follow-up was 9 months (3-24). Reduction of LUTS and micturition improvement in the USS-PROM questionnaire after the surgery was found in 90 patients (85%). The average IIEF-5 score in the whole group did not change significantly, but in 39 cases (37%) worsened, and in 42 (39%) improved. Spearman's rank-order correlation indicated a significant positive correlation between improvement in IIEF-5 and general QoL in EQ-5D and also a positive correlation between improvement in IIEF-5 and improvement in EQ-VAS, which was also statistically significant (rho = 0.377, p <0.001).
Urethral surgery can influence sexual performance. The appearance of sexual dysfunction negatively affects the patient's quality of life, regardless of the effective restoration of the urethral patency and reduction of LUTS.
本文旨在评估尿道成形术后性功能障碍对患者生活质量（QoL）及治疗满意度的影响。
我们研究了106例因尿道狭窄接受尿道成形术的性活跃患者。患者在治疗前后完成了尿道狭窄手术患者报告结局量表（USS - PROM）和国际勃起功能指数（IIEF - 5）问卷。采用Spearman等级相关进行相关性分析。使用多元线性回归和有序逻辑回归分析评估下尿路症状（LUTS）和IIEF - 5评分对欧洲五维度健康量表（EQ - 5D）指数、欧洲五维度视觉模拟量表（EQ - VAS）及治疗满意度的影响。在多元线性回归模型中，LUTS和IIEF - 5评分均为EQ - VAS的独立显著预测因素。
平均随访时间为9个月（3 - 24个月）。90例（85%）患者术后USS - PROM问卷中的LUTS减轻且排尿改善。全组平均IIEF - 5评分无显著变化，但39例（37%）恶化，42例（39%）改善。Spearman等级相关表明IIEF - 5改善与EQ - 5D总体QoL之间存在显著正相关，IIEF - 5改善与EQ - VAS改善之间也存在正相关，且具有统计学意义（rho = 0.377，p <0.001）。
尿道手术可影响性功能。性功能障碍的出现会对患者生活质量产生负面影响，无论尿道通畅性是否有效恢复及LUTS是否减轻。
