Impact of urethroplasty on male sexual function

Abstract EN

Purpose To evaluate the impact of anterior urethroplasty on male sexual function.

Patients and methods A total number of 35 patients with anterior urethral stricture who underwent urethroplasty at Assiut Urology and Nephrology Hospital from March 2015 to March 2016 were included in the study.

The mean age was 36.1 ± 11.1 years (range: 25–56 years).

Evaluation of postoperative erectile function was done using a validated questionnaire (International Index of Erectile Function-5 questionnaire) at 3 and 6 months posturethroplasty, while evaluation of ejaculatory and orgasmic function was done by using ejaculation/orgasm score at 3 and 6 months posturethroplasty.

Results The mean age of the included patients was 36.1 ± 11.1 years (range: 25–56 years).

As regards the incidence of Erectile dysfunction (ED) after urethroplasty, 3 months posturethroplasty, nine (25.7%) patients developed ED, with statistically significant difference (P = 0.001).

At 6 months posturethroplasty, just two (5.7%) patients showed ED, with no statistically significant difference (P = 0.15).

As regards the incidence of ED according to the etiology of urethral stricture, there was no statistically significant difference between postinflammatory and post-traumatic cases at 3 months (P = 0.636) and at 6 months (P = 0.234).

According to the length of urethral stricture, the impact on erectile function after urethroplasty was greater in shorter urethral stricture segment (1.9 ± 0.2 cm) than in longer urethral stricture segment (3.1 ± 1.3 cm) with no statistically significant difference between the two groups (P = 0.514).

ED occurred in anastomotic urethroplasty (39.1%) more than free graft urethroplasty (0%), with statistically significant difference (P = 0.012).

Conclusion Anterior urethroplasty has a probability of causing transient ED in as much as 25% of patients, with recovery of erectile function occurring in 78% of cases within 6 months of urethroplasty.

The incidence of ED is higher in patients undergoing anastomotic repair than in patients undergoing free graft urethroplasty.

Urethral reconstructive surgery has a minimal effect on ejaculatory and orgasmic functions.