Urethroplasty and Quality of Life: Psychometric Validation of a Dutch Version of the Urethral Stricture Surgery Patient Reported Outcome Measures

Abstract
Purpose: The study aimed to translate the Urethral Stricture Surgery Patient Reported Outcome Measures (USS-PROM) questionnaire in Dutch. To validate this translated questionnaire, the study evaluates its psychometric properties in a different population, a different environment, and a different health care system. Questions about urinary incontinence and sexual functioning were added. Materials and Methods: Between December 2014 and January 2017, Dutch-speaking adult men scheduled for urethroplasty at Ghent University Hospital were prospectively enrolled in this study. Patients completed the USS-PROM before surgery, 3-6 months after surgery, and 1 year after surgery. Psychometric criteria included content validity, criterion validity, internal consistency, reproducibility, responsiveness, and floor and ceiling effects. (EC/2014/0438). Results: A total of 100 patients were included, 39 patients completed both the preoperative and the postoperative questionnaire, and 30 patients completed the USS-PROM twice within a short period of time in order to evaluate test-retest reliability. Pearson correlation coefficients showed no statistical significant correlation between lower urinary tract symptoms (LUTS) scores and maximum flow rates. Cronbach's α was 0.81 and 0.89, respectively, for the LUTS score and the summative Male Sexual Health Questionnaire Ejaculatory Dysfunction short form (MSHQ-EjD short form) score. The intraclass correlation coefficients ranged from 0.72 to 0.94. Significant changes were observed in all items except the MSHQ-EjD short form scores. All values exceeded the predefined thresholds. Conclusions: The Dutch version of the USS-PROM has adequate psychometric properties and is a valid instrument to assess patient-reported outcome measures in men undergoing urethroplasty.