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Introduction: There is a paucity of patient reported outcome measure (PROM) data for women with urethral strictures. To address this gap, we aim to evaluate change in PROM among women who underwent surgery for a stricture. Methods: American Urological Association Symptom Index (AUA‐SI) and Urogenital Distress Inventory (UDI‐6) data from a multi‐institutional retrospective cohort study of women treated for urethral stricture was assessed. Results: Fifty‐seven women had either AUA‐SS or UDI‐6 and 26 had baseline and postoperative data for either. Most women underwent urethroplasty (77%) and the majority (73%) remained stricture free at median follow‐up of 21 months (interquartile range [IQR] 7–37). The median baseline AUA‐SI was 21 (IQR 12–28) and follow‐up was 10 (IQR 5–24). After treatment, there was a median decrease of 12 (IQR −18 to −2) in AUA‐SI (p = 0.003). The median AUA Quality of life (QOL) score at baseline and follow‐up were 6 (IQR 4–6) and 3 (IQR 2–5), respectively. There was a median AUA‐QOL improvement of 2 points (−5,0; p = 0.007) from a baseline 5 (unhappy) to 3 (mixed). Median UDI‐6 scores were 50 (IQR 33–75) at baseline and 17 (IQR 0–39), at follow‐up. After treatment, there was a median decrease of 19 (−31 to −11; p = 0.01). Conclusion: Women with urethral strictures have severe lower urinary tract symptoms which improved after surgery. This study substantiates the claims that recognizing and treating women with urethral stricture disease greatly improves lower urinary tract symptoms and QOL. [ABSTRACT FROM AUTHOR]

Background: Urinary incontinence (UI) is prevalent in women and has been associated with decreased quality of life and institutionalization. Despite this, and the fact that several treatment options exist, few women discuss UI with clinicians. The aim of this study was to examine the proportion of middle aged and older women with urinary incontinence who have discussed UI with clinicians, focusing on female health professionals as a way to examine this question outside of issues of health care access.Methods: Data are from the Nurses Health Studies (NHS), two ongoing observational, prospective, cohort studies. The surveys collected detailed information about UI, including frequency, amount and type. Women were also asked if they had discussed UI with a clinician. We used multivariable-adjusted logistic regression to estimate odds ratios (OR) of participants reporting discussion about UI.Results: 94,692 women with UI aged 49-91 years old were included in this study. Of these, 34% reported that they had discussed their incontinence with a clinician. Women with daily UI had 4.4 times greater odds of discussing it with clinicians when compared to those with monthly UI (OR = 4.36, 95% confidence interval [CI] 4.06-4.69). When controlling for severity of symptoms, the oldest women, greater than eighty years, were 20% less likely to have discussed UI with their clinician, compared to the youngest women (OR = 0.81, 95% CI 0.73-0.89).Conclusions: A minority of women with UI, even among health professionals, discuss their symptoms with clinicians. Oldest women were the least likely to discuss their UI with a provider. [ABSTRACT FROM AUTHOR]

Aim: Female urethral stricture disease is rare and has several surgical approaches including endoscopic dilations (ENDO), urethroplasty with local vaginal tissue flap (ULT) or urethroplasty with free graft (UFG). This study aims to describe the contemporary management of female urethral stricture disease and to evaluate the outcomes of these three surgical approaches. Methods: This is a multi‐institutional, retrospective cohort study evaluating operative treatment for female urethral stricture. Surgeries were grouped into three categories: ENDO, ULT, and UFG. Time from surgery to stricture recurrence by surgery type was analyzed using a Kaplan–Meier time to event analysis. To adjust for confounders, a Cox proportional hazard model was fit for time to stricture recurrence. Results: Two‐hundred and ten patients met the inclusion criteria across 23 sites. Overall, 64% (n = 115/180) of women remained recurrence free at median follow‐up of 14.6 months (IQR, 3–37). In unadjusted analysis, recurrence‐free rates differed between surgery categories with 68% ENDO, 77% UFG and 83% ULT patients being recurrence free at 12 months. In the Cox model, recurrence rates also differed between surgery categories; women undergoing ULT and UFG having had 66% and 49% less risk of recurrence, respectively, compared to those undergoing ENDO. When comparing ULT to UFG directly, there was no significant difference of recurrence. Conclusion: This retrospective multi‐institutional study of female urethral stricture demonstrates that patients undergoing endoscopic management have a higher risk of recurrence compared to those undergoing either urethroplasty with local flap or free graft. [ABSTRACT FROM AUTHOR]

Aims: This cross‐sectional study describes the catheter management of neurogenic bladder (NGB) in patients with traumatic spinal cord injury (tSCI) with emphasis on the motivations behind transitions between intermittent (IC) and indwelling catheters. Methods: Patients at the Minneapolis VA with history of tSCI who utilized either intermittent catheterization (IC), urethral (UC) or suprapubic (SP) catheters, participated in a voluntary, anonymous survey regarding their bladder management strategies. Results: A total of 100 patients participated, 94% were male and 90% Caucasian with median age of 61 years. Patients with current UC or SP were older than those utilizing IC (P = 0.002). The median age at injury and years since SCI were 32 years and 20.5 years, respectively. The median time with current modality was 11 years. A total of 27% of all patients reported at least one transition between catheter type. A total of 14 of 54 patients using IC had prior use of UC or SP, while 12/25 patients using SP and 10/21 patients using UC had prior use of IC. The most common reasons to stop IC included inconvenience, physician recommendation, and dislike of IC. A total of 53% of patients currently using UC or SP reported never using IC. Patients currently using SP were more content with their current catheterization method than those using UC or IC (P = 0.046). Conclusions: Among patients using catheters for NGB, intermittent catheterization was the most common modality utilized and the transition between intermittent and indwelling catheter was most often influenced by patient preferences and clinician recommendations. [ABSTRACT FROM AUTHOR]

Purpose Health related quality of life is increasingly important in quality improvement efforts for medical conditions. However, it has proved challenging to measure health related quality of life for urolithiasis, given the distinct chronic and acute phases of this disease. We evaluated the use of PROMIS® (Patient-Reported Outcomes Measurement System) to assess the patient experience through acute stone episode stages. Materials and Methods PROMIS pain measures (intensity and interference) were obtained from patients at a subspecialty kidney stone clinic. Four types of clinical encounters were considered, including emergency department followup, trial of passage, stent removal and 1-month postoperative findings. Raw scores were translated into population normed T-scores with a T-score of 50 considered the reference population mean and a score of 60 considered 1 SD above the mean. T-scores were compared across encounter types on univariate and multivariate analysis. Results A total of 2,018 complete surveys were available from 1,162 patients. Mean pain intensity and pain interference T-scores differed significantly by encounter type (p <0.001). On multivariate analysis the OR of T-scores greater than 60 was higher for pain intensity and interference for all encounter types relative to postoperative findings, including emergency department followup 37.9 vs 124.9, passage trial 5.4 vs 10.5 and stent removal 9.4 vs 30.2 (p <0.001). Additionally, female gender and younger age were independent risk factors for T-scores greater than 60. Conclusions PROMIS pain measures are responsive to the phase of care during symptomatic stone events. Further application of this instrument holds great potential as a valuable tool to improve the quality of urolithiasis care. [ABSTRACT FROM AUTHOR]

2 Sims describes that after one operation, "Lucy's agony was extreme ... and I thought that she was going to die ... It took Lucy 2 or 33 months to recover entirely from the effects of this operation." 1 Even though Sims uses the word "consent", Anarcha, Betsey and Lucy (and the other women whose names we do not know) were enslaved women. 20 April 2021 AUANEWS The urological community has come together to promote diversity, equity and inclusion in our workforce in support of societal efforts to condemn systemic racism and bias. [Extracted from the article]