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Lower Urinary Tract Pain and Anterior Urethral Stricture Disease: Prevalence and Effects of Urethral Reconstruction
Journal article   Open access   Peer reviewed

Lower Urinary Tract Pain and Anterior Urethral Stricture Disease: Prevalence and Effects of Urethral Reconstruction

Laura A Bertrand, Gareth J Warren, Bryan B Voelzke, Sean P Elliott, Jeremy B Myers, Christopher D McClung, Jacob J Oleson, Bradley A Erickson and TURNS
The Journal of urology, Vol.193(1), pp.184-189
01/2015
DOI: 10.1016/j.juro.2014.07.007
PMCID: PMC4307605
PMID: 25046621
url
https://doi.org/10.1016/j.juro.2014.07.007View
Published (Version of record) Open Access

Abstract

Anterior urethral stricture disease most commonly presents as urinary obstruction. Lower urinary tract pain is not commonly reported as a presenting symptom. We prospectively characterized lower urinary tract pain in association with urethral stricture disease and assessed the effects of urethroplasty on this pain. Men (18 years old or older) with anterior urethral stricture disease were prospectively enrolled in a longitudinal, multi-institutional, urethral reconstruction outcomes study from June 2010 to January 2013 as part of TURNS (Trauma and Urologic Reconstruction Network of Surgeons). Preoperative and postoperative lower urinary tract pain was assessed by the validated CLSS. Voiding and sexual function was assessed using validated patient-reported measures, including I-PSS. Preoperatively 118 of 167 men (71%) reported urethral pain and 68 (41%) reported bladder pain. Age was the only predictor of urethral pain with men 40 years or younger reporting more pain than those 60 years old or older (81% vs 58%, p = 0.0104). Lower urinary tract pain was associated with worse quality of life and overall voiding symptoms on CLSS and I-PSS (each p <0.01). Postoperatively lower urinary tract pain completely resolved in 64% of men with urethral pain and in 73.5% with bladder pain. There were no predictive factors for changes in lower urinary tract pain after urethral reconstruction. Lower urinary tract pain is common in urethral stricture disease, especially in younger men. It is associated with worse quality of life and voiding function. In most men lower urinary tract pain resolves after urethral reconstruction.
urethral stricture reconstructive surgical procedures pain lower urinary tract symptoms quality of life

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