Excision and Primary Anastomosis for Bulbar Urethral Strictures Improves Functional Outcomes and Quality of Life: A Prospective Analysis from a Single Centre
Background. Excision and primary anastomotic (EPA) urethroplasty remains the gold standard definitive treatment for short urethral stricture disease. For patients, postoperative erectile function and quality of life are the main goals of the surgery. Patient-reported outcome measures (PROMs) are the...
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| description | Background. Excision and primary anastomotic (EPA) urethroplasty remains the gold standard definitive treatment for short urethral stricture disease. For patients, postoperative erectile function and quality of life are the main goals of the surgery. Patient-reported outcome measures (PROMs) are therefore of major importance. Objective. The objective of this study was to prospectively analyse functional outcomes and patient satisfaction. Design, Settings, and Participants. We prospectively evaluated 47 patients before and after EPA from August 2009 until February 2017. The first follow-up visit occurred after a median of 2.2 months (n = 47/47), with the second and third follow-ups occurring at a median of 8.5 months (n = 38/47) and 20.2 months (n = 31/47). Before surgery and at each follow-up visit, the patients received five questionnaires: the International Prostate Symptom Score (IPSS), the International Prostate Symptom Score with the Quality of Life (IPSS-QOL) score, the Urogenital Distress Inventory Short Form (UDI-6) score, the International Index of Erectile Function-5 (IIEF-5) score, and the ICIQ-Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTS-QOL) score. Surgical Procedure. Surgery was performed in all cases using the same standardized EPA technique. Outcome Measurements and Statistical Analysis. Voiding symptoms, erectile dysfunction, and quality of life were analysed using paired sample t-tests, with a multiple-testing Bonferroni correction. Any requirement for instrumentation after surgery was considered treatment failure. Results and Limitations. Patients with mild or no baseline erectile dysfunction showed significant decline in erectile function at first follow-up (mean IIEF-5 of 23.27 [standard deviation; SD: 2.60] vs. 13.91 [SD: 7.50]; p=0.002), but this had recovered completely at the third follow-up (IIEF-5: 23.25 [SD: 1.91]; p=0.659). Clinically significant improvements were noted in IPSS, IPSS-QOL-score, UDI-6-score, and ICIQ-LUTS-QOL-score at the first follow-up (p |
| doi_str_mv | 10.1155/2019/7826085 |
| format | Article |
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Excision and primary anastomotic (EPA) urethroplasty remains the gold standard definitive treatment for short urethral stricture disease. For patients, postoperative erectile function and quality of life are the main goals of the surgery. Patient-reported outcome measures (PROMs) are therefore of major importance. Objective. The objective of this study was to prospectively analyse functional outcomes and patient satisfaction. Design, Settings, and Participants. We prospectively evaluated 47 patients before and after EPA from August 2009 until February 2017. The first follow-up visit occurred after a median of 2.2 months (n = 47/47), with the second and third follow-ups occurring at a median of 8.5 months (n = 38/47) and 20.2 months (n = 31/47). Before surgery and at each follow-up visit, the patients received five questionnaires: the International Prostate Symptom Score (IPSS), the International Prostate Symptom Score with the Quality of Life (IPSS-QOL) score, the Urogenital Distress Inventory Short Form (UDI-6) score, the International Index of Erectile Function-5 (IIEF-5) score, and the ICIQ-Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTS-QOL) score. Surgical Procedure. Surgery was performed in all cases using the same standardized EPA technique. Outcome Measurements and Statistical Analysis. Voiding symptoms, erectile dysfunction, and quality of life were analysed using paired sample t-tests, with a multiple-testing Bonferroni correction. Any requirement for instrumentation after surgery was considered treatment failure. Results and Limitations. Patients with mild or no baseline erectile dysfunction showed significant decline in erectile function at first follow-up (mean IIEF-5 of 23.27 [standard deviation; SD: 2.60] vs. 13.91 [SD: 7.50]; p=0.002), but this had recovered completely at the third follow-up (IIEF-5: 23.25 [SD: 1.91]; p=0.659). Clinically significant improvements were noted in IPSS, IPSS-QOL-score, UDI-6-score, and ICIQ-LUTS-QOL-score at the first follow-up (p<0.0001). These improvements remained significant at the second and third follow-ups (p<0.0001) for all PROMs. Three of the patients experienced stricture recurrence. The main limitations of this study were incomplete questionnaires, loss to follow-up, and low number of patients. Conclusions. EPA results in an initial decline in erectile function, but full recovery occurred at a median of 20 months. Voiding improved significantly, and a major improvement in quality of life was noted, which persisted for up to 20 months after surgery. Patient Summary. This study showed the importance of patient-reported outcome measures in indicating the actual outcome of urethral stricture disease surgery.</description><identifier>ISSN: 2314-6133</identifier><identifier>EISSN: 2314-6141</identifier><identifier>DOI: 10.1155/2019/7826085</identifier><identifier>PMID: 30809546</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Publishing Corporation</publisher><subject>Aged ; Anastomosis ; Anastomosis, Surgical ; Clinical Study ; Construction ; Erectile dysfunction ; Erectile Dysfunction - complications ; Erectile Dysfunction - epidemiology ; Erectile Dysfunction - physiopathology ; Humans ; Instrumentation ; Lower Urinary Tract Symptoms - complications ; Lower Urinary Tract Symptoms - epidemiology ; Lower Urinary Tract Symptoms - physiopathology ; Male ; Median (statistics) ; Medical treatment ; Middle Aged ; Patient Satisfaction ; Patients ; Penile Erection - physiology ; Prostate ; Prostatic Hyperplasia - complications ; Prostatic Hyperplasia - epidemiology ; Prostatic Hyperplasia - physiopathology ; Quality of Life ; Questionnaires ; Signs and symptoms ; Statistical analysis ; Stricture ; Success ; Surgeons ; Surgery ; Surveys and Questionnaires ; Survival analysis ; Urethra - physiopathology ; Urethra - surgery ; Urethral Stricture - epidemiology ; Urethral Stricture - physiopathology ; Urethral Stricture - surgery ; Urinary tract ; Urogenital system ; Urology</subject><ispartof>BioMed research international, 2019-01, Vol.2019 (2019), p.1-9</ispartof><rights>Copyright © 2019 Pieter D’hulst et al.</rights><rights>Copyright © 2019 Pieter D’hulst et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. https://creativecommons.org/licenses/by/4.0</rights><rights>Copyright © 2019 Pieter D'hulst et al. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c471t-ee8162a574a0f7ca31f32f4c817cfb58b01ba629013f70dc62e4e196936ebef53</citedby><cites>FETCH-LOGICAL-c471t-ee8162a574a0f7ca31f32f4c817cfb58b01ba629013f70dc62e4e196936ebef53</cites><orcidid>0000-0001-6407-4197</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364126/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6364126/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30809546$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Martins, Francisco E.</contributor><creatorcontrib>Joniau, Steven</creatorcontrib><creatorcontrib>Vander Eeckt, Kathy</creatorcontrib><creatorcontrib>Castiglione, Fabio</creatorcontrib><creatorcontrib>Floyd, Michael S.</creatorcontrib><creatorcontrib>D’hulst, Pieter</creatorcontrib><creatorcontrib>Van der Aa, Frank</creatorcontrib><title>Excision and Primary Anastomosis for Bulbar Urethral Strictures Improves Functional Outcomes and Quality of Life: A Prospective Analysis from a Single Centre</title><title>BioMed research international</title><addtitle>Biomed Res Int</addtitle><description>Background. Excision and primary anastomotic (EPA) urethroplasty remains the gold standard definitive treatment for short urethral stricture disease. For patients, postoperative erectile function and quality of life are the main goals of the surgery. Patient-reported outcome measures (PROMs) are therefore of major importance. Objective. The objective of this study was to prospectively analyse functional outcomes and patient satisfaction. Design, Settings, and Participants. We prospectively evaluated 47 patients before and after EPA from August 2009 until February 2017. The first follow-up visit occurred after a median of 2.2 months (n = 47/47), with the second and third follow-ups occurring at a median of 8.5 months (n = 38/47) and 20.2 months (n = 31/47). Before surgery and at each follow-up visit, the patients received five questionnaires: the International Prostate Symptom Score (IPSS), the International Prostate Symptom Score with the Quality of Life (IPSS-QOL) score, the Urogenital Distress Inventory Short Form (UDI-6) score, the International Index of Erectile Function-5 (IIEF-5) score, and the ICIQ-Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTS-QOL) score. Surgical Procedure. Surgery was performed in all cases using the same standardized EPA technique. Outcome Measurements and Statistical Analysis. Voiding symptoms, erectile dysfunction, and quality of life were analysed using paired sample t-tests, with a multiple-testing Bonferroni correction. Any requirement for instrumentation after surgery was considered treatment failure. Results and Limitations. Patients with mild or no baseline erectile dysfunction showed significant decline in erectile function at first follow-up (mean IIEF-5 of 23.27 [standard deviation; SD: 2.60] vs. 13.91 [SD: 7.50]; p=0.002), but this had recovered completely at the third follow-up (IIEF-5: 23.25 [SD: 1.91]; p=0.659). Clinically significant improvements were noted in IPSS, IPSS-QOL-score, UDI-6-score, and ICIQ-LUTS-QOL-score at the first follow-up (p<0.0001). These improvements remained significant at the second and third follow-ups (p<0.0001) for all PROMs. Three of the patients experienced stricture recurrence. The main limitations of this study were incomplete questionnaires, loss to follow-up, and low number of patients. Conclusions. EPA results in an initial decline in erectile function, but full recovery occurred at a median of 20 months. Voiding improved significantly, and a major improvement in quality of life was noted, which persisted for up to 20 months after surgery. Patient Summary. This study showed the importance of patient-reported outcome measures in indicating the actual outcome of urethral stricture disease surgery.</description><subject>Aged</subject><subject>Anastomosis</subject><subject>Anastomosis, Surgical</subject><subject>Clinical Study</subject><subject>Construction</subject><subject>Erectile dysfunction</subject><subject>Erectile Dysfunction - complications</subject><subject>Erectile Dysfunction - epidemiology</subject><subject>Erectile Dysfunction - physiopathology</subject><subject>Humans</subject><subject>Instrumentation</subject><subject>Lower Urinary Tract Symptoms - complications</subject><subject>Lower Urinary Tract Symptoms - epidemiology</subject><subject>Lower Urinary Tract Symptoms - physiopathology</subject><subject>Male</subject><subject>Median (statistics)</subject><subject>Medical treatment</subject><subject>Middle Aged</subject><subject>Patient Satisfaction</subject><subject>Patients</subject><subject>Penile Erection - physiology</subject><subject>Prostate</subject><subject>Prostatic Hyperplasia - complications</subject><subject>Prostatic Hyperplasia - epidemiology</subject><subject>Prostatic Hyperplasia - physiopathology</subject><subject>Quality of Life</subject><subject>Questionnaires</subject><subject>Signs and symptoms</subject><subject>Statistical analysis</subject><subject>Stricture</subject><subject>Success</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Surveys and Questionnaires</subject><subject>Survival analysis</subject><subject>Urethra - physiopathology</subject><subject>Urethra - surgery</subject><subject>Urethral Stricture - epidemiology</subject><subject>Urethral Stricture - physiopathology</subject><subject>Urethral Stricture - surgery</subject><subject>Urinary tract</subject><subject>Urogenital system</subject><subject>Urology</subject><issn>2314-6133</issn><issn>2314-6141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>RHX</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkUtvEzEUhUeIilZtd6yRJTZIkNaPsWeGBVKIWqgUqaDSteVxrhtXM-PgRyA_hv-Kh6RpYYU3vvL9dI7vPUXxkuAzQjg_p5g051VNBa75s-KIMlJOBCnJ833N2GFxGsI9zqcmAjfiRXHIcI0bXoqj4tfFT22DdQNSwwJ98bZXfoOmgwrR9S7YgIzz6GPqWuXRrYe49KpDN9FbHZOHgK76lXfrXFymQccslNvXKWrX57dR82tSnY0b5AyaWwPv0TTbuLCCTK9htOo2f3y865FCN3a46wDNYIgeTooDo7oAp7v7uLi9vPg2-zyZX3-6mk3nE11WJE4A8mRU8apU2FRaMWIYNaWuSaVNy-sWk1YJ2mDCTIUXWlAogTSiYQJaMJwdFx-2uqvU9rDQo7nq5Gq7DumUlX93BruUd24tBRMloSILvNkJePc9QYiyt0FD16kBXAqSkloIKijDGX39D3rvks9bGKmKU0apGAXfbSmddxU8mP1nCJZj9HKMXu6iz_irpwPs4YegM_B2CyztsFA_7H_KQWbAqEea0IoLxn4De1LClA</recordid><startdate>20190101</startdate><enddate>20190101</enddate><creator>Joniau, Steven</creator><creator>Vander Eeckt, Kathy</creator><creator>Castiglione, Fabio</creator><creator>Floyd, Michael S.</creator><creator>D’hulst, Pieter</creator><creator>Van der Aa, Frank</creator><general>Hindawi Publishing Corporation</general><general>Hindawi</general><general>Hindawi Limited</general><scope>ADJCN</scope><scope>AHFXO</scope><scope>RHU</scope><scope>RHW</scope><scope>RHX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7QO</scope><scope>7T7</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>CWDGH</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-6407-4197</orcidid></search><sort><creationdate>20190101</creationdate><title>Excision and Primary Anastomosis for Bulbar Urethral Strictures Improves Functional Outcomes and Quality of Life: A Prospective Analysis from a Single Centre</title><author>Joniau, Steven ; Vander Eeckt, Kathy ; Castiglione, Fabio ; Floyd, Michael S. ; D’hulst, Pieter ; Van der Aa, Frank</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c471t-ee8162a574a0f7ca31f32f4c817cfb58b01ba629013f70dc62e4e196936ebef53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Anastomosis</topic><topic>Anastomosis, Surgical</topic><topic>Clinical Study</topic><topic>Construction</topic><topic>Erectile dysfunction</topic><topic>Erectile Dysfunction - complications</topic><topic>Erectile Dysfunction - epidemiology</topic><topic>Erectile Dysfunction - physiopathology</topic><topic>Humans</topic><topic>Instrumentation</topic><topic>Lower Urinary Tract Symptoms - complications</topic><topic>Lower Urinary Tract Symptoms - epidemiology</topic><topic>Lower Urinary Tract Symptoms - physiopathology</topic><topic>Male</topic><topic>Median (statistics)</topic><topic>Medical treatment</topic><topic>Middle Aged</topic><topic>Patient Satisfaction</topic><topic>Patients</topic><topic>Penile Erection - physiology</topic><topic>Prostate</topic><topic>Prostatic Hyperplasia - complications</topic><topic>Prostatic Hyperplasia - epidemiology</topic><topic>Prostatic Hyperplasia - physiopathology</topic><topic>Quality of Life</topic><topic>Questionnaires</topic><topic>Signs and symptoms</topic><topic>Statistical analysis</topic><topic>Stricture</topic><topic>Success</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Surveys and Questionnaires</topic><topic>Survival analysis</topic><topic>Urethra - physiopathology</topic><topic>Urethra - surgery</topic><topic>Urethral Stricture - epidemiology</topic><topic>Urethral Stricture - physiopathology</topic><topic>Urethral Stricture - surgery</topic><topic>Urinary tract</topic><topic>Urogenital system</topic><topic>Urology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Joniau, Steven</creatorcontrib><creatorcontrib>Vander Eeckt, Kathy</creatorcontrib><creatorcontrib>Castiglione, Fabio</creatorcontrib><creatorcontrib>Floyd, Michael S.</creatorcontrib><creatorcontrib>D’hulst, Pieter</creatorcontrib><creatorcontrib>Van der Aa, Frank</creatorcontrib><collection>الدوريات العلمية والإحصائية - e-Marefa Academic and Statistical Periodicals</collection><collection>معرفة - المحتوى العربي الأكاديمي المتكامل - e-Marefa Academic Complete</collection><collection>Hindawi Publishing Complete</collection><collection>Hindawi Publishing Subscription Journals</collection><collection>Hindawi Publishing Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Middle East & Africa Database</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BioMed research international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Joniau, Steven</au><au>Vander Eeckt, Kathy</au><au>Castiglione, Fabio</au><au>Floyd, Michael S.</au><au>D’hulst, Pieter</au><au>Van der Aa, Frank</au><au>Martins, Francisco E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Excision and Primary Anastomosis for Bulbar Urethral Strictures Improves Functional Outcomes and Quality of Life: A Prospective Analysis from a Single Centre</atitle><jtitle>BioMed research international</jtitle><addtitle>Biomed Res Int</addtitle><date>2019-01-01</date><risdate>2019</risdate><volume>2019</volume><issue>2019</issue><spage>1</spage><epage>9</epage><pages>1-9</pages><issn>2314-6133</issn><eissn>2314-6141</eissn><abstract>Background. Excision and primary anastomotic (EPA) urethroplasty remains the gold standard definitive treatment for short urethral stricture disease. For patients, postoperative erectile function and quality of life are the main goals of the surgery. Patient-reported outcome measures (PROMs) are therefore of major importance. Objective. The objective of this study was to prospectively analyse functional outcomes and patient satisfaction. Design, Settings, and Participants. We prospectively evaluated 47 patients before and after EPA from August 2009 until February 2017. The first follow-up visit occurred after a median of 2.2 months (n = 47/47), with the second and third follow-ups occurring at a median of 8.5 months (n = 38/47) and 20.2 months (n = 31/47). Before surgery and at each follow-up visit, the patients received five questionnaires: the International Prostate Symptom Score (IPSS), the International Prostate Symptom Score with the Quality of Life (IPSS-QOL) score, the Urogenital Distress Inventory Short Form (UDI-6) score, the International Index of Erectile Function-5 (IIEF-5) score, and the ICIQ-Lower Urinary Tract Symptoms Quality of Life (ICIQ-LUTS-QOL) score. Surgical Procedure. Surgery was performed in all cases using the same standardized EPA technique. Outcome Measurements and Statistical Analysis. Voiding symptoms, erectile dysfunction, and quality of life were analysed using paired sample t-tests, with a multiple-testing Bonferroni correction. Any requirement for instrumentation after surgery was considered treatment failure. Results and Limitations. Patients with mild or no baseline erectile dysfunction showed significant decline in erectile function at first follow-up (mean IIEF-5 of 23.27 [standard deviation; SD: 2.60] vs. 13.91 [SD: 7.50]; p=0.002), but this had recovered completely at the third follow-up (IIEF-5: 23.25 [SD: 1.91]; p=0.659). Clinically significant improvements were noted in IPSS, IPSS-QOL-score, UDI-6-score, and ICIQ-LUTS-QOL-score at the first follow-up (p<0.0001). These improvements remained significant at the second and third follow-ups (p<0.0001) for all PROMs. Three of the patients experienced stricture recurrence. The main limitations of this study were incomplete questionnaires, loss to follow-up, and low number of patients. Conclusions. EPA results in an initial decline in erectile function, but full recovery occurred at a median of 20 months. Voiding improved significantly, and a major improvement in quality of life was noted, which persisted for up to 20 months after surgery. Patient Summary. This study showed the importance of patient-reported outcome measures in indicating the actual outcome of urethral stricture disease surgery.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Publishing Corporation</pub><pmid>30809546</pmid><doi>10.1155/2019/7826085</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0001-6407-4197</orcidid><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6364126 |
| source | MEDLINE; Wiley Online Library Open Access; PubMed Central; Alma/SFX Local Collection; PubMed Central Open Access |
| subjects | Aged Anastomosis Anastomosis, Surgical Clinical Study Construction Erectile dysfunction Erectile Dysfunction - complications Erectile Dysfunction - epidemiology Erectile Dysfunction - physiopathology Humans Instrumentation Lower Urinary Tract Symptoms - complications Lower Urinary Tract Symptoms - epidemiology Lower Urinary Tract Symptoms - physiopathology Male Median (statistics) Medical treatment Middle Aged Patient Satisfaction Patients Penile Erection - physiology Prostate Prostatic Hyperplasia - complications Prostatic Hyperplasia - epidemiology Prostatic Hyperplasia - physiopathology Quality of Life Questionnaires Signs and symptoms Statistical analysis Stricture Success Surgeons Surgery Surveys and Questionnaires Survival analysis Urethra - physiopathology Urethra - surgery Urethral Stricture - epidemiology Urethral Stricture - physiopathology Urethral Stricture - surgery Urinary tract Urogenital system Urology |
| title | Excision and Primary Anastomosis for Bulbar Urethral Strictures Improves Functional Outcomes and Quality of Life: A Prospective Analysis from a Single Centre |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-15T15%3A00%3A59IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Excision%20and%20Primary%20Anastomosis%20for%20Bulbar%20Urethral%20Strictures%20Improves%20Functional%20Outcomes%20and%20Quality%20of%20Life:%20A%20Prospective%20Analysis%20from%20a%20Single%20Centre&rft.jtitle=BioMed%20research%20international&rft.au=Joniau,%20Steven&rft.date=2019-01-01&rft.volume=2019&rft.issue=2019&rft.spage=1&rft.epage=9&rft.pages=1-9&rft.issn=2314-6133&rft.eissn=2314-6141&rft_id=info:doi/10.1155/2019/7826085&rft_dat=%3Cproquest_pubme%3E2175232266%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2175232266&rft_id=info:pmid/30809546&rfr_iscdi=true |