The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA.
Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA.
Asian J Androl. 2022 Nov-Dec;24(6):570-574. doi: 10.4103/aja2021110.
Due to growing social acceptance, there has been an increasing number of gender-affirmation surgeries performed in North America. Most research in this patient population focuses on surgical outcomes and advancing techniques. However, little work has been done to study functional outcomes. To better evaluate urinary dysfunction in the postphalloplasty trans men patient population, our group developed a novel patient-reported outcome instrument - the postphalloplasty urinary function test (PP UFT) and protocol to measure postvoid urethral volume (PVUR), and we present our preliminary results. We conducted a cross-sectional pilot study in a cohort of 15 adult trans men who had undergone phalloplasty with urethral lengthening surgery between 2018 and 2021. Patients had stable urinary function via the neophallus at the time of survey. Patients filled out the PP UFT and were asked to record their PVUR as per our protocol. The average PP UFT score was 8.9 out of 40 and the average quality-of-life (QOL) score was 2.6. Postvoid dribbling constituted the major complaint and on average comprised 63.2% of the reported PP UFT score. The average PVUR was 2.2 ml (range: 0.5-5.6 ml). There was a positive correlation between higher PP UFT and worse-reported quality of life (P < 0.01; R = 0.4). Current questionnaires accepted in cis-male urology have limitations for accurately capturing urinary dysfunction in this specific patient group. The combination of PP UFT and PVUR measurement offers potential for quantifying urinary function and quality of life in patients who undergo phalloplasty. Future studies will validate these instruments.
由于社会认可度的提高，北美地区进行的性别肯定手术数量不断增加。大多数针对该患者群体的研究都集中在手术结果和技术进步上。然而，在研究功能结果方面做得很少。为了更好地评估后阴茎成形术男性跨性别者患者群体的尿功能障碍，我们小组开发了一种新的患者报告结局工具——后阴茎成形术尿功能测试（PP UFT）和测量排尿后尿道体积（PVUR）的方案，并呈现我们的初步结果。我们在 2018 年至 2021 年间接受过阴茎成形术和尿道延长术的 15 名成年跨男性进行了一项横断面试点研究。在调查时，患者通过新阴茎稳定了尿功能。患者填写了 PP UFT，并按照我们的方案记录他们的 PVUR。PP UFT 的平均得分为 40 分中的 8.9 分，生活质量（QOL）得分为 2.6。排尿后滴沥是主要抱怨，平均占报告的 PP UFT 评分的 63.2%。平均 PVUR 为 2.2 毫升（范围：0.5-5.6 毫升）。PP UFT 越高，报告的生活质量越差（P<0.01；R=0.4），这两者之间存在正相关关系。目前在 cis 男性泌尿科中接受的问卷在准确捕捉该特定患者群体的尿功能障碍方面存在局限性。PP UFT 和 PVUR 测量的结合为评估接受阴茎成形术的患者的尿功能和生活质量提供了潜力。未来的研究将验证这些工具。
