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Urethral Reconstruction Outcomes Using Patient Reported Preoperative And Postoperative Questionnaires In Combination With Uroflometry
Jessica DeLong, Jill Buckley
The Lahey Clinic, Burlington, MA

Introduction: There is a paucity of data regarding self-reported outcomes following urethral reconstruction. We compared preoperative and postoperative AUA symptom score (AUASS), quality of life (QOL), erectile function, flow rate (FR), and post-void residual (PVR) in patients undergoing urethral reconstruction for complex stricture disease.
Materials & Methods: Under an IRB-approved chart review, 86 patients were identified with complete pre and postoperative data, and an additional 20 patients with only postoperative data. All cases were performed at our institution over a 2.5-year period. Patient demographics, type of surgery, AUASS, QOL score, IEFF, FR and PVR were collected for all patients. Patients were followed at 3 and 6 months postoperatively, then yearly with questionnaires, FR and PVR. Flexible cystoscopy (17fr) was performed at 6 months. Statistical analysis was performed using the Wilcoxon signed rank test.
Results: Average patient age was 46.8 (range 17-81) years. Twenty-two anastomotic, 73 onlay and 11 fasciocutaneous flap urethroplasties were performed. The median individual change when comparing pre and postoperative data in our cohort was an improvement of 12 for AUASS, 4 for QOL, and no change in IIEF (table 1).
Conclusions:
Patients undergoing urethral reconstruction for complex stricture disease experienced a significant improvement in self-reported outcomes that correlated with functional uroflow studies. Patients can expect to maintain their erectile function. This data may be helpful when counseling patients prior to surgical intervention.

Median preoperative and postoperative patient reported and diagnostic data
PreoperativePostoperativeMedian Changep-value
AUA symptom score162-12<0.0001
QOL51-4<0.0001
IIEF232410.2155
FR92312<0.0001
PVR6624-32<0.0001


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