Journal article
Effect of Urethroplasty on Anxiety and Depression
The Journal of urology, Vol.199(6), pp.1552-1556
06/2018
DOI: 10.1016/j.juro.2018.01.074
PMID: 29408454
Abstract
To our knowledge anxiety and depression in patients with urethral stricture disease and the impact of urethroplasty on mental health has never been explored. We hypothesized that patients with urethral stricture disease would have higher than normal anxiety and depression levels, and urethroplasty would improve mental health.
We retrospectively reviewed the records of patients in a multi-institutional reconstructive urology database who underwent anterior urethroplasty. Preoperative and postoperative evaluation of anxiety and depression, and overall health was recorded using the validated EQ-5D™-3L Questionnaire. Sexual function was evaluated with the IIEF (International Index of Erectile Function) and the Men’s Sexual Health Questionnaire. Stricture recurrence was defined as the need for a subsequent procedure.
Median followup in the 298 patients who met study inclusion criteria was 4.2 months. Preoperative anxiety and depression was reported by 86 patients (29%). Those with anxiety and depression reported higher rates of marijuana use, a worse preoperative IIEF score (17.5 vs 19.6, p = 0.01) and a lower image of overall health (66 vs 79, p ≤0.001). Improvement or resolution of anxiety and depression was experienced by 56% of patients treated with urethroplasty while de novo postoperative anxiety and depression were reported by 10%. These men reported a decreased flow rate (16 vs 25 ml per second, p = 0.01). Clinical failure in 8 patients (2.7%) had no effect on the development, improvement or resolution of anxiety and depression.
Of patients with preoperative anxiety and depression 56% reported improvement or resolution after urethroplasty. Although new onset anxiety and depression was rare, these patients had a significantly lower postoperative maximum flow rate, possibly representing a group with a perceived suboptimal surgical outcome. A urethral stricture disease specific questionnaire is needed to further elucidate the interplay of urethral stricture disease with anxiety and depression.
Details
- Title: Subtitle
- Effect of Urethroplasty on Anxiety and Depression
- Creators
- Jared P Schober - Department of Urology, Lahey Hospital and Medical Center, Burlington, MassachusettsKristian D Stensland - Department of Urology, Lahey Hospital and Medical Center, Burlington, MassachusettsBenjamin N Breyer - Departments of Urology and Epidemiology and Biostatistics, University of California-San Francisco, San Diego, CaliforniaBradley A Erickson - Department of Urology, University of Iowa, Iowa City, IowaJeremy B Myers - Division of Urology, University of Utah, Salt Lake City, UtahBryan B Voelzke - Department of Urology, University of Washington, Seattle, WashingtonSean P Elliott - Department of Urology, University of Minnesota, Minneapolis, MinnesotaJill C Buckley - Department of Urology, University of California-San Diego, San Diego, CaliforniaAlex J Vanni - Department of Urology, Lahey Hospital and Medical Center, Burlington, Massachusetts
- Resource Type
- Journal article
- Publication Details
- The Journal of urology, Vol.199(6), pp.1552-1556
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.juro.2018.01.074
- PMID
- 29408454
- ISSN
- 0022-5347
- eISSN
- 1527-3792
- Language
- English
- Date published
- 06/2018
- Academic Unit
- Urology
- Record Identifier
- 9984051798002771
Metrics
9 Record Views