A Prospective Study of Patient-reported Pain After Bulbar Urethroplasty

Patrick Evans; Sorena Keihani; Benjamin N Breyer; Bradley A Erickson; James M Hotaling; Sara M Lenherr; Jeremy B Myers

doi:10.1016/j.urology.2018.02.046

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A Prospective Study of Patient-reported Pain After Bulbar Urethroplasty

Journal article

Open access

Peer reviewed

A Prospective Study of Patient-reported Pain After Bulbar Urethroplasty

Patrick Evans, Sorena Keihani, Benjamin N Breyer, Bradley A Erickson, James M Hotaling, Sara M Lenherr and Jeremy B Myers

Urology (Ridgewood, N.J.), Vol.117, pp.156-162

07/2018

DOI: 10.1016/j.urology.2018.02.046

PMID: 29656064

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Abstract

To understand the prevalence of chronic perineal pain, activity limitations, and patient satisfaction after urethroplasty. From 2014 to 2016, we prospectively enrolled men undergoing urethroplasty for bulbar urethral strictures. Patients, before and after surgery, completed questions from the Core Lower Urinary Tract Symptom Score assessing pain frequency in the bladder and penis or urethra, as well as nonvalidated questions assessing perineal pain. Overall satisfaction with their current urinary condition and pain-related activity limitations at home, work, or during exercise were also measured. Patients with <3 months of follow-up were excluded. Pre-and postoperative scores were compared using the Wilcoxon signed-rank test. Thirty-five men were included in the study. Mean age and body mass index were 44.6 years and 30.9 kg/m , respectively. Urethroplasties were anastomotic in 24 (69%) and were single-stage buccal graft substitution in 11 (31%). Median follow-up after surgery was 483 days (range: 90-810 days). A total of 10 patients (29%) reported worsening perineal pain intensity after surgery, whereas 8 (23%) reported improvement and 17 (48%) reported no change. Overall, pain frequency in the bladder, penis or urethra, and perineum improved. Home and exercise pain-related activity restrictions improved significantly after surgery. Satisfaction with current urinary condition also improved with 91% reporting feeling "delighted," "pleased," or "mostly satisfied" with their current condition. Patients are highly satisfied with their urinary condition after urethroplasty. Pain frequency in the bladder and the urethra significantly improves after urethroplasty; however, perineal pain intensity can worsen and become chronic after surgery in some patients.

Pain, Postoperative - etiology

Urethra - surgery

Prospective Studies

Urethral Stricture - complications

Humans

Middle Aged

Male

Mouth Mucosa - transplantation

Perineum

Patient Satisfaction

Urethral Stricture - surgery

Pelvic Pain - etiology

Penis

Urologic Surgical Procedures, Male

Adult

Anastomosis, Surgical

Urinary Bladder

Patient Reported Outcome Measures

Details

Title: Subtitle: A Prospective Study of Patient-reported Pain After Bulbar Urethroplasty
Creators: Patrick Evans - Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT
Sorena Keihani - Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT. Electronic address: sorena.keihani@hsc.utah.edu
Benjamin N Breyer - Department of Urology, University of San Francisco California, San Francisco, CA
Bradley A Erickson - Department of Urology, University of Iowa, Iowa City, IA
James M Hotaling - Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT
Sara M Lenherr - Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT
Jeremy B Myers - Division of Urology, Department of Surgery, University of Utah, Salt Lake City, UT
Resource Type: Journal article
Publication Details: Urology (Ridgewood, N.J.), Vol.117, pp.156-162
DOI: 10.1016/j.urology.2018.02.046
PMID: 29656064
NLM abbreviation: Urology
ISSN: 0090-4295
eISSN: 1527-9995
Publisher: United States
Grant note: DOI: 10.13039/100008497, name: Boston Scientific
Language: English
Date published: 07/2018
Academic Unit: Urology
Record Identifier: 9984051592102771

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