title: Turkish validation of the urethral stricture surgery specific patient-reported outcome measure (USS-PROM) with supplemental assessment of erectile function and morbidity due to oral graft harvesting.
abstract: OBJECTIVE
  We validated a Turkish language version of the urethral stricture surgery specific patient-reported outcome measure (USS-PROM) in men undergoing anterior urethroplasty. We also investigated changes in erectile function (EF) and quality of life (QoL) due to oral mucosa graft (OMG) harvesting.
  
  
  METHODS
  The USS-PROM captures lower urinary tract symptoms (LUTS), health related QoL (HRQoL) with EQ-5D visual analogue scale (EQ-VAS). To evaluate EF and OMG morbidity, we used International Index of Erectile Function (IIEF-5) and a self-completed questionnaire, respectively. Psychometric assessment of USS-PROM included test-retest reliability, internal consistency, criterion validity, and responsiveness. Objective evidence for urethroplasty success was demonstrated with fluoroscopic imaging and urethral calibration at post-operative six months.
  
  
  RESULTS
  Among the 101 men included during study period, 42 had complete pre- and postoperative 6th month data for analysis. The test-retest intraclass correlation was 0.79. Cronbach's α for internal consistency of the LUTS construct was 0.79. There was a significant negative correlation between total LUTS scores and peak flow rates, both preoperatively (r = -0.478) and postoperatively (r = -0.508). Mean baseline EQ-VAS increased from 70 to 84 postoperatively (P < 0.001), indicating improved HRQoL. IIEF scores did not change significantly after urethroplasty. Early and late-term QoL impairment rates due to OMG harvesting were 28.9 and 13.1%, respectively. Three (7.1%) men required endoscopic intervention for recurrence within 6 months.
  
  
  CONCLUSIONS
  Turkish version of USS-PROM showed comparable psychometric properties with the original version. Complementation of this instrument with additional measures that address sexual function and OMG morbidity provides better QoL assessment for urethral reconstruction.
authors.affiliation: Onol Urology, Istanbul, Turkey.
authors.forename: Fikret Fatih
authors.initials: FF
authors.lastname: Önol
authors.affiliation: Department of Urology, Umraniye Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Bindayi
authors.affiliation: Department of Urology, Umraniye Training and Research Hospital, Istanbul, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Tahra
authors.affiliation: Onol Urology, Istanbul, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Basibuyuk
authors.affiliation: Onol Urology, Istanbul, Turkey.
authors.forename: Sinasi Yavuz
authors.initials: SY
authors.lastname: Onol
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D007172:Erectile Dysfunction / Q000453:epidemiology*; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000453:epidemiology*; D009061:Mouth Mucosa / Q000637:transplantation*; D000071066:Patient Reported Outcome Measures; D011183:Postoperative Complications / Q000453:epidemiology*; D011594:Psychometrics; D011788:Quality of Life; D019651:Plastic Surgery Procedures; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014521:Urethra / Q000503:physiopathology / Q000601:surgery*; D014525:Urethral Stricture / Q000503:physiopathology / Q000601:surgery*; D055815:Young Adult
keywords: patient-reported outcomes measures; quality of life; urethroplasty