Chinese validation of urethral stricture surgery specific patient-reported outcome measure (USS-PROM) and evaluation of the outcome of urethroplasty for anterior urethral strictures at a single institution

Abstract

Objectives: To validate a Chinese language version of USS-PROM in men undergoing urethroplasty for anterior urethral stricture, and to evaluate outcomes at a single institution. Patients & Methods: A Chinese version of USS-PROM was carried out using double-forward translation by two independent translators. Patients were asked to complete the PROM with uroflowmetry assessment before (baseline) and 3 to 6 monthly after urethroplasty. The PROM was evaluated for internal consistency, test-retest reliability, criterion validity, and responsiveness. Non-Chinese speaking men, aged <18, catheterised patients and posterior urethroplasty patients were excluded. Results: Thirty-five urethoplasties were carried out between October 2017 and July 2021, including 13 bulbar urethroplasties and 22 distal urethroplasties or salvage hypospadias repair. 20 patients were eligible for the study. Cronbach’s alpha was 0.80. Mean total-LUTS score improved from 13.4 at baseline to 5.08 at 6 months after surgery (p = 0.004, 95% CI 3.18 – 13.4). Mean Peeling’s picture score improved from 3.15 to 2.00 (p = 0.003, 95% CI 0.46 – 1.84). Mean Qmax improved from 12.5ml/s to 23.2ml/s (p = 0.001). Mean RU improved from 71.3ml to 20.5ml (p = 0.098). The mean EQ-VAS score was increased from 63.8 to 77.1 (p = 0.046). The erectile function score remains similar (2.50 vs 2.42, p = 0.586). Overall, 95% were satisfied or very satisfied with urethroplasty. One patient required revision urethroplasty. Conclusion: The Chinese version of the USS-PROM has adequate psychometric properties and is a valid instrument to assess PROM in men undergoing anterior urethroplasty. This study also demonstrated that urethroplasty is able to provide excellent outcomes.