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Psychometric validation of a German language version of a PROM for urethral stricture surgery and preliminary testing of supplementary ED and UI constructs

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Abstract

Purpose

To validate a German language version of the patient-reported outcome measurement (PROM) following urethral stricture surgery (USS) in a cohort of men undergoing one-stage buccal mucosa graft urethroplasty (BMGU) for urethral stricture. Furthermore, to explore the responsiveness of erectile function (EF) and urinary incontinence (UI) constructs in the context of this intervention.

Methods

The USS-PROM captures voiding symptoms (ICIQ-MLUTS) and health-related quality of life (HRQoL) (EQ-5D). To evaluate EF and UI, the IIEF-5 and ICIQ-UI SF were included. Between March 2012 and April 2013, all patients undergoing BMGU at our institution were prospectively enrolled in this study. Psychometric assessment included internal consistency, test–retest reliability, criterion validity and responsiveness.

Results

Ninety-three men completed the USS-PROM before and 3 months after surgery, with 40 (43 %) also completing the USS-PROM 6 months after surgery to assess reliability. Internal consistency: for the ICIQ-MLUTS, Cronbach’s α was 0.83. The test–retest intraclass correlation coefficient was 0.94. There was a negative correlation between change in ICIQ-MLUTS total score and change in Q max (r = −0.40). All values exceeded our predefined thresholds. Significant improvements of voiding symptoms and HRQoL demonstrate responsiveness to change (all p values <0.001). While ICIQ-UI scores did not change (p > 0.05), IIEF-5 scores improved significantly (p = 0.048).

Conclusions

The German language USS-PROM shows similar psychometric properties to the English language version. This instrument can be improved by assessing EF by the use of IIEF-5. Further studies with larger patient cohorts are needed to evaluate the significance of measuring UI in urethroplasty patients.

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References

  1. Andrich DE, Mundy AR (2008) What is the best technique for urethroplasty? Eur Urol 54:1031–1041

    Article  PubMed  Google Scholar 

  2. Mundy AR, Andrich DE (2011) Urethral strictures. BJU Int 107:6–26

    Article  PubMed  Google Scholar 

  3. Kluth LA, Dahlem R, Reiss P et al (2013) Short-term outcome and morbidity of different contemporary urethroplasty techniques—a preliminary comparison. J Endourol 27:925–929

    Article  PubMed  Google Scholar 

  4. van Leeuwen MA, Brandenburg JJ, Kok ET et al (2011) Management of adult anterior urethral stricture disease: nationwide survey among urologists in the Netherlands. Eur Urol 60:159–166

    Article  PubMed  Google Scholar 

  5. Santucci R, Eisenberg L (2010) Urethrotomy has a much lower success rate than previously reported. J Urol 183:1859–1862

    Article  PubMed  Google Scholar 

  6. Santucci RA, Joyce GF, Wise M (2007) Male urethral stricture disease. J Urol 177:1667–1674

    Article  PubMed  Google Scholar 

  7. DeLong J, Buckley J (2013) Patient-reported outcomes combined with objective data to evaluate outcomes after urethral reconstruction. Urology 81:432–436

    Article  PubMed  Google Scholar 

  8. Nuss GR, Granieri MA, Zhao LC et al (2012) Presenting symptoms of anterior urethral stricture disease: a disease specific, patient reported questionnaire to measure outcomes. J Urol 187:559–562

    Article  PubMed  Google Scholar 

  9. http://www.ichom.org

  10. Jackson MJ, Chaudhury I, Mangera A et al (2013) A prospective patient-centred evaluation of urethroplasty for anterior urethral stricture using a validated patient-reported outcome measure. Eur Urol 64:777–782

    Article  PubMed  Google Scholar 

  11. Jackson MJ, Sciberras J, Mangera A et al (2011) Defining a patient-reported outcome measure for urethral stricture surgery. Eur Urol 60:60–68

    Article  PubMed  Google Scholar 

  12. Voelzke BB (2013) Critical review of existing patient reported outcome measures after male anterior urethroplasty. J Urol 189:182–188

    Article  PubMed  Google Scholar 

  13. Barbagli G, Lazzeri M (2011) Patient’s reported outcome and reconstructive urethral surgery: a “first toe in the water”. Eur Urol 60:69–71 (discussion 71)

    Article  PubMed  Google Scholar 

  14. Donovan JL, Abrams P, Peters TJ et al (1996) The ICS-‘BPH’ Study: the psychometric validity and reliability of the ICSmale questionnaire. Br J Urol 77:554–562

    Article  CAS  PubMed  Google Scholar 

  15. Donovan JL, Peters TJ, Abrams P et al (2000) Scoring the short form ICSmaleSF questionnaire. J Urol 164:1948–1955

    Article  CAS  PubMed  Google Scholar 

  16. Peeling WB (1989) Diagnostic assessment of benign prostatic hyperplasia. Prostate Suppl 2:51–68

    Article  CAS  PubMed  Google Scholar 

  17. The EuroQol Group (1990) EuroQol—a new facility for the measurement of health-related quality of life. Health Policy 16:199–208

    Article  Google Scholar 

  18. Avery K, Donovan J, Peters TJ et al (2004) ICIQ: a brief and robust measure for evaluating the symptoms and impact of urinary incontinence. Neurourol Urodyn 23:322–330

    Article  PubMed  Google Scholar 

  19. Rosen RC, Riley A, Wagner G et al (1997) The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 49:822–830

    Article  CAS  PubMed  Google Scholar 

  20. Dawson J, Doll H, Fitzpatrick R et al (2010) The routine use of patient reported outcome measures in healthcare settings. BMJ 340:c186

    Article  PubMed  Google Scholar 

  21. Aaronson N, Alonso J, Burnam A et al (2002) Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res 11:193–205

    Article  PubMed  Google Scholar 

  22. Nunnally JC, Bernstein IH (1994) Psychometric theory, 3rd edn. McGraw-Hill, New York

    Google Scholar 

  23. Smith S, Cano S, Lamping D et al (2005) Patient-reported outcome measures (PROMs) for routine use in treatment centres: recommendations based on a review of the scientific evidence. UK London School of Hygiene & Tropical Medicine, London

    Google Scholar 

  24. Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310

    Article  CAS  PubMed  Google Scholar 

  25. Terwee CB, Bot SD, de Boer MR et al (2007) Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 60:34–42

    Article  PubMed  Google Scholar 

  26. Martin NE, Massey L, Stowell C et al (2015) Defining a standard set of patient-centered outcomes for men with localized prostate cancer. Eur Urol 67(3):460–467

    Article  PubMed  Google Scholar 

  27. Barbagli G, Romano G, Sansalone S et al (2011) Italian validation of the English PROM-USS-Q questionnaire in patients undergoing anterior urethroplasty. Urologia 78:98–107

    PubMed  Google Scholar 

  28. Johnson EK, Latini JM (2011) The impact of urethroplasty on voiding symptoms and sexual function. Urology 78:198–201

    Article  PubMed  Google Scholar 

  29. Kessler TM, Fisch M, Heitz M et al (2002) Patient satisfaction with the outcome of surgery for urethral stricture. J Urol 167:2507–2511

    Article  PubMed  Google Scholar 

  30. Coursey JW, Morey AF, McAninch JW et al (2001) Erectile function after anterior urethroplasty. J Urol 166:2273–2276

    Article  CAS  PubMed  Google Scholar 

  31. Anger JT, Sherman ND, Webster GD (2007) The effect of bulbar urethroplasty on erectile function. J Urol 178:1009–1011 (discussion 1011)

    Article  PubMed  Google Scholar 

  32. Xie H, Xu YM, Xu XL et al (2009) Evaluation of erectile function after urethral reconstruction: a prospective study. Asian J Androl 11:209–214

    Article  PubMed Central  PubMed  Google Scholar 

  33. Erickson BA, Granieri MA, Meeks JJ et al (2010) Prospective analysis of erectile dysfunction after anterior urethroplasty: incidence and recovery of function. J Urol 183:657–661

    Article  PubMed  Google Scholar 

  34. Sharma V, Kumar S, Mandal AK et al (2011) A study on sexual function of men with anterior urethral stricture before and after treatment. Urol Int 87:341–345

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

All persons gave their informed consent prior to their inclusion in the study.

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    Authors and Affiliations

    1. Department of Urology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany

      Luis A. Kluth, Roland Dahlem, Andreas Becker, Marianne Schmid, Armin Soave, Clemens Rosenbaum, Tim A. Ludwig, Natalie Christ, Michael Rink, Philip Reiss, Oliver Engel, Silke Riechardt, Felix K.-H. Chun, Margit Fisch & Sascha A. Ahyai

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    1. Luis A. Kluth
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    2. Roland Dahlem
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    Correspondence to Luis A. Kluth.

    Additional information

    Luis A. Kluth and Roland Dahlem have contributed equally to this manuscript.

    Margit Fisch and Sascha A. Ahyai are seniors.

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    Kluth, L.A., Dahlem, R., Becker, A. et al. Psychometric validation of a German language version of a PROM for urethral stricture surgery and preliminary testing of supplementary ED and UI constructs. World J Urol 34, 369–375 (2016). https://doi.org/10.1007/s00345-015-1610-8

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    • DOI: https://doi.org/10.1007/s00345-015-1610-8

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