Psychometric and Linguistic External Validation of the Urethral Stricture Symptom and Impact Measure and Its Association With Treatment Satisfaction and Decision Regret After Anterior Urethroplasty.
prospective_cohort · Level II
Where this comes from
- Record sourced from PubMed, PMID 42054622.
- Also identified by DOI 10.1097/JU.0000000000005072.
- No licence information is recorded for this record.
- Because redistribution is not established, this page shows the abstract only. Follow the links below for the full text.
Abstract
The Urethral Stricture Symptom and Impact Measure (USSIM) is a patient-derived patient reported outcome measure (PROM) for men undergoing urethroplasty, but external and linguistic validation is lacking. We aimed to validate the USSIM in an independent cohort and further examine its association with treatment satisfaction and decisional regret. From September 2023 to September 2024, 151 male patients undergoing anterior urethroplasty were prospectively enrolled; 100 completed both baseline and 3-9 month postoperative PROMs. The 12-item USSIM was translated into German following the ICIQ validation methodology and was administered together with the USS-PROM LUTS, and MSHQ-Ej, ICIQ-Satisfaction and the Decision Regret Scale. Psychometric evaluation followed COSMIN standards, assessing reliability, validity, and responsiveness. Of 100 patients with pre- and postoperative PROMs available, most patients underwent single-stage urethroplasty (94%), with bulbar (75%) or penile (25%) strictures, predominantly idiopathic (40%) or iatrogenic (31%), and median stricture length of 30 mm (IQR 20-40). Postoperative assessment occurred at a median of six months (IQR 4-7). Internal consistency of the 10-item postoperative scale was good (Cronbach α = 0.869). Test-retest reliability was high (intraclass correlation coefficient [ICC] = 0.88). Changes in USSIM voiding scores strongly correlated with USS-PROM LUTS improvements (Spearman rank correlation coefficient [r<sub>s</sub>] = 0.72, p<0.001), weakly with MSHQ-Ej changes (r<sub>s</sub> = -0.25, p=0.015), moderately with treatment satisfaction (r<sub>s</sub> = -0.37, p<0.001), and moderately with decision regret (r<sub>s</sub> = 0.32, p=0.001). Total USSIM scores (reference range: 10-50) decreased significantly postoperatively (median change -10; p < 0.001), demonstrating high responsiveness. This first external psychometric and linguistic validation confirms that the USSIM is a reliable, valid, and responsive instrument for assessing urinary and sexual outcomes after anterior urethroplasty. It provides a standardized, patient-centered tool for postoperative follow-up and comparative research.