Predictors of the international prostate symptoms scores for patients with lower urinary tract symptoms: A descriptive cross-sectional study

Background: Lower urinary tract symptoms (LUTSs) can significantly reduce men's quality of life and may point to serious pathology of the urogenital tract. This study aimed at finding predictors of symptoms score on the International Prostate Symptom Score (IPSS) for patients with LUTS. Materials and Methods: The study was cross-sectional conducted among 225 Ghanaian men visiting the urology clinic at Komfo Anokye Teaching Hospital. Trained interviewers used the IPSS, which adds a quality of life question to the American Urology Association symptom index to determine the extent to which patients are troubled by their symptoms. Five milliliters of blood was collected for total prostate-specific antigen (PSA) measurement. Transrectal ultrasonography was performed to evaluate the prostate volume (PV). Results: The mean age of the participants was 67.96 ± 14.57. The average score obtained from the study participants using the IPSS scale was 17.52 ± 7.83. There was a significant association between bother score and IPSS symptoms grade (P < 0.0001). Regression plot of the participants' points for IPSS in relation to the age, PSA, and PV showed statistically significant positive associations (P < 0.05). However, the coefficients of determination (R2) were 0.156, 0.022, and 0.048, respectively. This means that each unit increase of age, PSA, and PV only influences 15.6%, 2.3%, and 4.8% of the change in the symptom score. There was statistically significant association between age and moderate-to-severe LUTS with age range of 75 years above recording the highest odds (adjusted odds ratio (AOR) = 18.72, (1.15–99.78), P < 0.0001). The PSA range 20.1–50 ng/ml was significantly associated with moderate-to-severe LUTS (AOR = 17.37 (2.19–223.45), P = 0.006). Moreover, other factors, which were significantly associated with moderate-to-severe LUTS, were smoking (AOR = 0.32 (0.11–0.94) P = 0.038) and being widowed (AOR = 0.05 (0.002–0.52), P =0.010) respectively. Conclusion: The study found a statistically significant correlation between age, PSA, PV, and IPSS scores; however, these influences were mild

Dorsal Onlay Oral Mucosa Graft Urethroplasty: A Case Report and Review of Literature

The use of buccal mucosa grafts in urethral reconstruction for complex anterior urethral strictures has gained popularity over the years with very good outcomes reported in literature. We report on the successful repair of a complex anterior urethral stricture in a 14-year-old boy following catheterization using this method at the Komfo Anokye Teaching Hospital. The aim is to describe the method of dorsal onlay oral mucosa graft urethroplasty and to review the literature

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways