Psychometric and Linguistic External Validation of the Urethral Stricture Symptom and Impact Measure and Its Association With Treatment Satisfaction and Decision Regret After Anterior Urethroplasty.

PURPOSE: The Urethral Stricture Symptom and Impact Measure (USSIM) is a patient-derived patient reported outcome measure (PROM) for men undergoing urethroplasty, but external and linguistic validation is lacking. We aimed to validate the USSIM in an independent cohort and further examine its association with treatment satisfaction and decisional regret. MATERIALS 100 completed both baseline and 3-9 month postoperative PROMs. The 12-item USSIM was translated into German following the ICIQ validation methodology and was administered together with the USS-PROM LUTS, and MSHQ-Ej, ICIQ-Satisfaction and the Decision Regret Scale. Psychometric evaluation followed COSMIN standards, assessing reliability, validity, and responsiveness. RESULTS: = 0.32, p=0.001). Total USSIM scores (reference range: 10-50) decreased significantly postoperatively (median change -10; p < 0.001), demonstrating high responsiveness. CONCLUSIONS: This first external psychometric and linguistic validation confirms that the USSIM is a reliable, valid, and responsive instrument for assessing urinary and sexual outcomes after anterior urethroplasty. It provides a standardized, patient-centered tool for postoperative follow-up and comparative research.