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Pelvic floor dysfunction in young men with anterior urethral stricture disease
Amy Zheng, MD, Peris Castaneda, MD, Alex Vanni, MD.
Lahey Hospital & Medical Center, Burlington, MA, USA.
BACKGROUND: Lower urinary tract pain is common in urethral stricture disease (USD), especially in younger men. While pain usually resolves after reconstruction, 25% of men report persistent pain suggesting alternative etiology. Pelvic floor dysfunction (PFD) is one such etiology with symptoms that can mimic those of USD. Our study explores the prevalence of PFD in younger men (18-40 years) with anterior USD while comparing the clinical characteristics of these USD patients with and without PFD.
METHODS: Using the TriNetX database, male patients with anterior USD and PFD were identified with International Classification of Diseases-10 (ICD) coding. Demographics, comorbidities, and treatment patterns were analyzed between young USD men with and without PFD using descriptive statistics.
RESULTS: We identified 8,993 young men aged 18-40 with a diagnosis of anterior urethral stricture disease. The prevalence of PFD was 9.6% (n=864). Comparison of demographics, comorbidities, and treatments for young USD men with and without PFD is shown in Table 1. Compared to young men without PFD, young USD men with PFD were more likely to have diabetes mellitus, anxiety/depressive disorders, and traumatic etiology for their stricture. Men with PFD were more likely to pursue urethroplasty (29% versus 24% in non-PFD patients). In addition, young USD men with PFD were more likely to be referred to physical therapy.
CONCLUSIONS: About 1 in 10 young men with USD may also have underlying PFD. Young men with USD and PFD have significant differences in comorbidities and treatment compared to those without PFD. Further insight on presentation and outcomes of young USD men with PFD could lead to improved and earlier diagnosis and intervention in this special population.
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