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Multicenter Study
. 2014 Jan;191(1):143-7.
doi: 10.1016/j.juro.2013.06.054. Epub 2013 Jun 29.

Poor quality of life in patients with urethral stricture treated with intermittent self-dilation

Jessica D Lubahn  1 , Lee C Zhao  1 , J Francis Scott  1 , Steven J Hudak  1 , Justin Chee  2 , Ryan Terlecki  3 , Benjamin Breyer  4 , Allen F Morey  5
Affiliations
Multicenter Study

Poor quality of life in patients with urethral stricture treated with intermittent self-dilation

Jessica D Lubahn et al. J Urol. 2014 Jan.

Abstract

Purpose: We assessed patient perceptions of regular intermittent self-dilation in men with urethral stricture.

Materials and methods: We constructed and distributed a visual analog questionnaire to evaluate intermittent self-dilation via catheterization by men referred for urethral stricture management at a total of 4 institutions. Items assessed included patient duration, frequency, difficulty and pain associated with intermittent self-dilation as well as interference of intermittent self-dilation with daily activity. The primary outcome was patient perceived quality of life. Multivariate analysis was performed to assess factors that affected this outcome.

Results: Included in the study were 85 patients with a median age of 68 years, a median of 3.0 years on intermittent self-dilation and a median frequency of 1 dilation per day. On a 1 to 10 scale the median intermittent self-dilation difficulty was 5.0 ± 2.7, the median pain score was 3.0 ± 2.7 and median interference with daily life was 2.0 ± 1.3. Overall quality of life in patients with stricture was poor (median score 7.0 ± 2.6 with poor quality of life defined as 7 or greater). On univariate analysis younger age (p <0.01), interference (p = 0.03), pain (p <0.01) and difficulty performing intermittent self-dilation (p = 0.03) correlated with poor quality of life in a statistically significant manner. On multivariate analysis only difficulty catheterizing (p <0.01) and younger age (p = 0.05) were statistically significant predictors. Patients with stricture involving the posterior urethra had a statistically significant increase in difficulty and decrease in quality of life (each p = 0.04).

Conclusions: Most patients with urethral stricture who are on intermittent self-dilation rate difficulty and pain as moderate, and inconvenience as low but report poor quality of life.

Keywords: ISC; ISD; QOL; catheterization; contracture; intermittent self-catheterization; intermittent self-dilation; quality of life; questionnaires; urethral stricture; urinary bladder neck obstruction.

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Figures

Figure 1
Figure 1
Visual analog scale
Figure 2
Figure 2
Association of younger age with poor QOL score
Figure 3
Figure 3
Association of stricture site with QOL score in patients with ISD.
See this image and copyright information in PMC

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