Outcomes of urethroplasty in patients with proximal bulbar urethral stricture following transurethral surgery for benign prostatic hyperplasia: A focus on continence and patient-reported outcome measures

Introduction: The study aimed to evaluate the impact of changes in urinary continence on postoperative quality of life (QoL) and patient satisfaction after urethroplasty for proximal bulbar urethral stricture following transurethral resection of the prostate (post-TURP PBUS). Methods: We retrospectively reviewed 34 patients who underwent urethroplasty for post-TURP PBUS at two centers between November 2013 and August 2024. Patients with complete pre- and postoperative data from a validated patient-reported outcome measure (PROM) and the International Consultation on Incontinence Questionnaire–Urinary Incontinence Short Form (ICIQ-SF), along with postoperative cystoscopic findings, were included. Worsening continence (WC) was defined as an increase in ICIQ-SF total score at 6 months. Stricture-free (SF) status was defined as the smooth passage of a cystoscope. The impact of WC and SF status on postoperative QoL and patient satisfaction was analyzed. Results: Among the 34 patients (excision and primary anastomosis: 13, nontransecting anastomotic urethroplasty: 20, and onlay augmentation: 1), 32 (94%) achieved SF status. WC occurred in 5 (14%) patients, while 33 (97%) remained socially pad-free. Although ICIQ-SF scores showed no significant change ( P = 0.15), QoL scores improved significantly ( P < 0.01). Notably, none of the WC(+) patients reported worsened QoL or dissatisfaction. No significant differences in clinical characteristics were observed between the WC(+) and WC(−) groups. Conclusions: Urethroplasty for post-TURP PBUS appears to have minimal impact on continence and is associated with high QoL and satisfaction. This study is among the first to systematically evaluate these outcomes using validated PROMs in this specific population.