ORLANDO, FL USA (UroToday.com) - Anterior urethral stricture disease most commonly presents with manifestations of urinary obstruction; lower urinary tract pain (LUTP) is not commonly reported as a presenting symptom. Because pain can be associated with higher healthcare costs, Bertrand and colleagues conducted a prospective study to characterize LUTP in association with urethral stricture disease and assess the effects of urethroplasty on this pain.
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Men (≥ 18) with anterior urethral stricture disease were prospectively enrolled in a longitudinal, multi-institutional, urethral reconstruction outcomes study (June 2010 – January 2013) as part of the Trauma and Urologic Reconstruction Network of Surgeons. Pre- and post-operative LUTP was assessed via the validated Core Lower Urinary Tract Symptom Score (CLSS). Voiding and sexual function were assessed using multiple validated patient-reported measures, including the International Prostate Symptom Score (IPSS).
A total of 167 men were included in the study. Preoperatively, 118/167 (71%) men reported urethral pain and 68 (41%) reported bladder pain. Age was the only predictor of urethral pain with men ≤ 40 years old reporting more pain than men ≥ 60 (81% vs 58%; p = 0.0104). LUTP was associated with worse quality of life and overall voiding symptoms on the CLSS and IPSS (all p < 0.01). Postoperatively, the majority of men had complete resolution of their LUTP (64% of urethral pain and 73.5% of bladder pain). There were no predictive factors for changes in LUTP after urethral reconstruction.
LUTP is common in urethral stricture disease, especially in younger men, and is associated with worse quality of life and with voiding function. In the majority of men, LUTP improves after urethral reconstruction.
Presented by Laura Bertrand, MD at the American Urological Association (AUA) Annual Meeting- May 16 - 21, 2014 - Orlando, Florida USA
Iowa City, IA USA
Written by Zhamshid Okhunov, MD, University of California (Irvine), and medical writer for UroToday.com