Patient satisfaction and associated factors after urethroplasty for urethral stricture disease in northern Tanzania: a prospective cohort study

Résumé

Purpose: Patient satisfaction after urethroplasty is underexplored, as traditional outcome assessments rely on objective measures, like imaging and invasive tests, overlooking patients’ perspectives and the associated factors that influence their overall experience.

Materials and methods: A prospective cohort study was conducted between August 2024 and July 2025 at Kilimanjaro Christian Medical Centre (KCMC), a tertiary referral hospital in northern Tanzania. Male patients undergoing urethroplasty for urethral stricture disease were consecutively enrolled using convenience sampling. Preoperative and three-month postoperative assessments were done using the Urethral Stricture Surgery Patient-Reported Outcome Measure (USS-PROM) tool. Data on demographics, clinical characteristics, symptoms, postoperative treatment satisfaction at three months, and quality of life (QoL) were collected using a Swahili-translated questionnaire. Data were analysed using IBM SPSS version 25, with paired t-tests and relative risk used to assess changes and associations.

Results: A total of 32 male patients (mean age 54 ± 19 years) underwent urethroplasty. Trauma was the most common cause (75%), and the bulbar urethra was the most affected site (78%). At the three-month follow-up, 81.3% of patients reported being very satisfied with their surgical outcomes, while 18.7% were dissatisfied. Among satisfied patients, significant improvements were observed in lower urinary tract symptom (LUTS) severity, QoL, and urine stream (p < 0.001). Dissatisfaction was associated with age ≥ 45 years, immediate postoperative complications, stricture recurrence, and lower USS-PROM score reductions in LUTS and QoL domains (p < 0.05).

Conclusion: Most patients reported high satisfaction with urethroplasty outcomes. However, dissatisfaction was linked to older age, complications, and poor symptom improvement. Our findings underscore the value of incorporating patient-reported outcome measures (PROM) in routine postoperative follow-up.