Validación psicométrica de la versión en castellano del cuestionario USS-PROM para pacientes sometidos a cirugía de uretra anterior / Psychometric validation of the Spanish version of the USS-PROM questionnaire for patients who undergo anterior urethral surgery

Objetivo: Traducir y validar en lengua castellana el cuestionario Urethral Stricture Surgery Patient-Reported Outcome Measure (USS-PROM), evaluar sus propiedades psicométricas y determinar su idoneidad para su uso clínico en nuestro medio. Adicionalmente, se valoraron los posibles cambios en la función eyaculatoria mediante el Male Sexual Health Questionnaire-Ejaculatory Dysfunction (MSHQ-EjD). Material y métodos: Se realizó una traducción sistemática de la versión británica. De forma prospectiva, entre septiembre 2014 y septiembre 2015 se incluyeron pacientes programados para cirugía de estenosis de uretra anterior. Todos los pacientes completaron el cuestionario antes y después de la cirugía. Se realizó un estudio psicométrico en profundidad del cuestionario. Resultados: Se evaluaron las respuestas de un total de 40 pacientes. El cuestionario demostró su validez presentando excelente correlación negativa entre las puntuaciones de los síntomas de vaciado y el flujo máximo (r = −0,6, p < 0,001), y mostrando también mejoría significativa en el EQ5D-visual analogue scale (VAS) y el time trade-off (TTO). Para la consistencia interna, el alfa de Cronbach fue de 0,701. Para la fiabilidad test-retest el coeficiente de correlación intraclase (CCI) global fue de 0,974 y los CCI de cada ítem por separado oscilaron entre 0,799 y 0,980. Se observaron mejoras significativas en todos los ítems de síntomas miccionales y calidad de vida relacionada con la salud (CVRS) (p < 0,001), quedando demostrada la capacidad de respuesta al cambio del cuestionario. No observamos cambios significativos en el MSHQ-EjD. Conclusiones: La versión en castellano del cuestionario USS-PROM es un instrumento válido para cuantificar los cambios en los síntomas de vaciado y la CVRS de los pacientes sometidos a cirugía de uretra anterior

Ojective: To translate into Spanish and validate the Urethral Stricture Surgery Patient-Reported Outcome Measure (USS-PROM) questionnaire, assessing its psychometric properties and determining its suitability for clinical use in our community. We also assessed the potential changes in ejaculatory function using the Male Sexual Health Questionnaire-Ejaculatory Dysfunction (MSHQ-EjD). Material and methods: A systematic translation of the British version was performed. Patients scheduled for anterior urethral stricture surgery between September 2014 and September 2015 were prospectively included in the study. All patients completed the questionnaire before and after the surgery. We conducted an in-depth psychometric study of the questionnaire. Results: We assessed the responses of a total of 40 patients. The questionnaire showed its validity, presenting an excellent negative correlation between the voiding symptom scores and the maximum flow (r = −0.6,P < .001), and also showed significant improvement in the EQ5D-VAS (visual analogue scale) and the time trade-off. For internal consistency, the Cronbach's alpha was 0.701. For the test-retest reliability, the overall intraclass correlation coefficient (ICC) was 0.974, and the ICC for each item separately ranged from 0.799 to 0.980. We observed significant improvement in all items regarding urinary symptoms and health-related quality of life (P < .001), thereby demonstrating the response capacity to changing the questionnaire. There were no significant changes in the MSHQ-EjD. Conclusions: The Spanish version of the USS-PROM questionnaire is a valid instrument for quantifying changes in voiding symptoms and the health-related quality of life of patients undergoing anterior urethral surgery

Psychometric validation of the Spanish version of the USS-PROM questionnaire for patients who undergo anterior urethral surgery. / Validación psicométrica de la versión en castellano del cuestionario USS-PROM para pacientes sometidos a cirugía de uretra anterior.

OBJECTIVE: To translate into Spanish and validate the Urethral Stricture Surgery Patient-Reported Outcome Measure (USS-PROM) questionnaire, assessing its psychometric properties and determining its suitability for clinical use in our community. We also assessed the potential changes in ejaculatory function using the Male Sexual Health Questionnaire-Ejaculatory Dysfunction (MSHQ-EjD). MATERIAL AND METHODS: A systematic translation of the British version was performed. Patients scheduled for anterior urethral stricture surgery between September 2014 and September 2015 were prospectively included in the study. All patients completed the questionnaire before and after the surgery. We conducted an in-depth psychometric study of the questionnaire. RESULTS: We assessed the responses of a total of 40 patients. The questionnaire showed its validity, presenting an excellent negative correlation between the voiding symptom scores and the maximum flow (r=-0.6, P<.001), and also showed significant improvement in the EQ5D-VAS (visual analogue scale) and the time trade-off. For internal consistency, the Cronbach's alpha was 0.701. For the test-retest reliability, the overall intraclass correlation coefficient (ICC) was 0.974, and the ICC for each item separately ranged from 0.799 to 0.980. We observed significant improvement in all items regarding urinary symptoms and health-related quality of life (P<.001), thereby demonstrating the response capacity to changing the questionnaire. There were no significant changes in the MSHQ-EjD. CONCLUSIONS: The Spanish version of the USS-PROM questionnaire is a valid instrument for quantifying changes in voiding symptoms and the health-related quality of life of patients undergoing anterior urethral surgery.

Primary renal lymphoma: long-term results of two patients treated with a chemotherapy + rituximab protocol.

Primary renal lymphoma (PRL) is a rare disease of which the etiology and pathogenesis remain controversial, and there is currently no standard treatment for it. We present the results of a long-term followup of two patients who were diagnosed with PRL and treated with cyclophosphamide, adriamycin, vincristine, prednisolone and rituximab (CHOP + R) regimen. Both patients reached a complete response, and there is no evidence of recurrence after 4.5- and 5-year followup periods. Based on our experience and other recently published studies, we recommend the combination of CHOP + rituximab as the elective treatment for this disease. To our knowledge, this is the longest followup period with a complete response that has been reported with this modality of treatment.

[Epidermoid carcinoma of the male urethra. Our experience in 5 cases]. / Carcinoma epidermoide de uretra masculina. Nuestra experiencia en cinco casos.

OBJECTIVES: Epidermoid carcinoma of the male urethra is a rare tumor that accounts for 70% of primary neoplasms of the urethra. The present study reviews our experience of 5 years in the diagnosis and treatment of this tumor type. METHODS: From 1991 to 1994, we diagnosed and treated 5 male patients with epidermoid carcinoma of the urethra; mean age 58 years (range 43 to 76 years). The tumor was localized in the bulbomembranous urethra in 3 cases (60%) and in the penile urethra in the remaining 2 cases (40%). All patients presented with urethral stricture and complications following treatment (internal urethrotomy and dilatation). The tumors of the posterior urethra were Levine stage C and D at the time of diagnosis, while those of the anterior urethra were Levine stage B and C. RESULTS: Two patients with tumor in the posterior urethra underwent radical cystoprostatourethrectomy and bilateral inguinal lymphadenectomy, whereas the remaining patients underwent emasculation or urethrectomy. Patient survival has ranged from 1 to 2.5 years at the present time. One patient with tumor in the bulbous urethra has died despite postoperative radio and chemotherapy, the outcome has been poor in another patient with tumor in the posterior urethra and no progression has been observed in the remaining patients at present. CONCLUSIONS: a) Urethral stricture with a torpid course and localized complications (fistula, periurethral abscess, etc.) following standard therapy have been the only widely accepted etiologic factors that we have observed in our patients; b) This tumor type must be suspected since treatment by radical surgery will have some likelihood of success if the carcinoma is diagnosed early, while it is still localized; c) To date, radio and chemotherapy have achieved poor results, the former being effective in tumors of the penile urethra only when given at a high dose; d) Patients generally die from localized complications, tumor recurrence, or lymph node metastasis (sepsis, hemorrhage, etc.).