Patient Reported Outcome Measures Following Urethroplasty in Kenyatta National Hospital

Abstract

Background: patient reported outcomes in urethroplasty have become increasingly valuable in assessing success of urethroplasty and in postoperative monitoring. This study determines the status of patient reported outcomes after urethral reconstruction. Objectives: to determine short term patient reported outcomes of urethroplasty at the Kenyatta National Hospital Study Design: The study design applied in this study is an observational prospective study design. Study sample:sample size will be calculated using krejcie formula with a sample size of 65 patients. methodology: patients were sampled consecutively until the sample size was met Patient demographics, location of stricture, length of stricture and management offered were obtained. USS-PROM questionnaire was administered preoperatively and four weeks postoperatively. Results. 64 patients completed the uss-proms questionnaire pre and post operatively with a mean age of 39.14 (SD 14.04). majority of the patients had bulbur urethral stricture (56.2%) followed by membranous. The etiology of urethral stricture in this group varied from trauma (57.8%), infections (14.1%), inflammatory (10.9%) and idiopatihic cause (0.2%). The patients were offered different forms of urethroplasty with excision primary anastomosis accounting for 56.7%, 23.3% underwent augmentation urethroplasty with buccal mucosal graft and 18.3% underwent DVIU.58 patients had post operative improvement improvement in their LUTS domain (mean difference of 0.32 to 2.87)and QOL domains (EQ-5D). 78% were either satisfied or very satisfied with the outcomes of urethroplasty. 14 patients(21.9)were not satisfied with the surgery, of this patients 7(53.8%)reported there was improvement in urinary symptoms but had developed other problems, 6 (46.2%) had no improvement in urinary symptoms. Conclusion: uss-prom enables reliable assessment of men with urethral stricture disease, both pre and post operatively. Although majority of the patients (78%) reported improvement of their lower urinary tract symptoms and quality of life 14% were not satisfied. Dissatisfaction did not coorelate with the outcomes of surgery.