Erectile and Ejaculatory Dysfunction After Urethroplasty

Heinsimer, Kevin; Wiegand, Lucas

doi:10.1007/s11934-021-01039-9

Cited by 7 publications

(6 citation statements)

References 61 publications

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“…It has been postulated that, the causes of de novo erectile dysfunction following urethroplasty might be multi-factorial and may occur due to disruption of the bulbar arteries or cavernosalspongiosal branches during mobilizing or transecting the bulbar urethra, or disruption of the cavernous or perineal nerves during splitting the bulbospongiosus muscle to expose the underlying corpus spongiosum [9]. Also, psychosomatic causes might have a role in the onset of erectile dysfunction as well [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

“…For anterior urethroplasties, some degree of ED is not uncommon, but this tends to be transient, with most patients having resolution of their de novo ED within 12 months post-operatively [12].…”

Section: Discussionmentioning

confidence: 99%

“…It includes items concerning maintenance capacity, erection confidence, maintenance frequency, and erection firmness along with one item concerning intercourse satisfaction. Grades of erectile dysfunction on SHIM scores are classified into severe erectile dysfunction (SHIM score: 5-7), moderate (8)(9)(10)(11), mild-to-moderate (12)(13)(14)(15)(16), mild (17)(18)(19)(20)(21), and no erectile dysfunction (22)(23)(24)(25).…”

Section: Methodsmentioning

confidence: 99%

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Male Sexual Dysfunction after Anterior Urethroplasty: Results from a Tertiary Center

Elnashrty,

Elbendary,

Elgamal

et al. 2023

JAMMR

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Background: It has been proved that urethral stricture disease (USD) affects patient’s quality of life (QoL) significantly. Various treatment approaches for management of USD exist, however open urethroplasty is considered as the mainstay technique being an efficient and durable method for managing USD. The aim of this work was to evaluate sexual dysfunction in patients subjected to surgical repair of anterior urethral stricture. Methods: This prospective cohort study was conducted on 85 cases with clinical criteria of urethral stricture disease undergoing anterior urethral reconstructive surgery in the period from May 2020 to May 2022 at Tanta University Hospitals. Patients suffering pelvic fracture urethral injury (PFUI) or posterior urethral stenosis were excluded. Retrograde urethrography and uroflometry were performed. In addition, a detailed sexual history and a validated sexual health inventory for men (SHIM) questionnaire was filled by the patients before as well as following surgery. Results: 74 patients (87.1%) reported no change in their sexual symptoms, while the patient (1.2%) who had a preoperative penile curvature showed an improvement of his curvature post-operatively. Nine patients (10.6%) developed de novo ED, while 2 patients reported having a shortening of penis (2.4%). Meanwhile, less frequent sexual problems were encountered such as cold glans, a reduced sensation of ejaculation and failure of emission in 3.5% of patients collectively. All the patients with ejaculatory dysfunction showed an improvement except the patient who presented with failure of emission. Four patients (5.3%) showed an improvement of their transient postoperative ED while 4 patients had persistent ED. There were two more patients, one developed penile curvature and the other complained of prostatitis symptoms associated with haematospermia. Conclusions: The present study demonstrated that anterior urethroplasty may be associated with transient ED in nearly 6.25 % of patients. Recovery of erectile function was depicted in approximately half of cases within 6-9 months of surgery. There was no difference in the incidence of denovo ED in patients undergoing anastomotic repair and in patients undergoing augmentation urethroplasty. Urethral lumen restoration may be associated with improvement of pre ejaculatory dysfunction.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Male Sexual Dysfunction after Anterior Urethroplasty: Results from a Tertiary Center

Elnashrty,

Elbendary,

Elgamal

et al. 2023

JAMMR

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“…While initially concerns about urethral reconstruction were mainly focussed on stricture recurrence, more recently, due to the high success rate of modern urethroplasty techniques, sexual function after urethral surgery has received more attention [41][42][43]. This particularly refers to attempts at its preservation.…”

Section: Non-transecɵng Transecɵngmentioning

confidence: 99%

Outcomes of transecting versus non‐transecting urethroplasty for bulbar urethral stricture: a meta‐analysis

Oszczudłowski

Yepes²,

Dobruch

et al. 2023

BJU International

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ObjectivesTo assess outcomes of transecting vs non‐transecting urethroplasty for bulbar urethral stricture in terms of stricture recurrence rate, sexual dysfunction, and patient‐reported outcome measures (PROMs) related to lower urinary tract (LUT) function.MethodsElectronic literature searches were conducted using PubMed, Cochrane Library, Web of Science and Embase databases. The studied population was limited to men with bulbar urethral stricture included in studies that compared outcomes after transecting and non‐transecting urethroplasty. The main outcome appraised was the stricture recurrence rate. Additionally, the incidence of sexual dysfunction appraised in three domains (erectile function, penile complications, and ejaculatory function) and PROMs related to LUT function after transecting vs non‐transecting urethroplasty were assessed. The pooled risk ratio (RR) respectively for stricture recurrence, erectile dysfunction and penile complications was calculated using a fixed‐effect model with inverse variance method.ResultsIn all, 694 studies were screened with 72 identified as relevant. Finally, 19 studies were suitable for analysis. The pooled difference between the transecting and non‐transecting groups relating to stricture recurrence was not significant. Overall, the RR was 1.06 (95% confidence interval [CI] 0.82–1.36) and the 95% CI crossed the line of no effect (line RR = 1). Overall, the RR for erectile dysfunction was 0.73 (95% CI 0.49–1.08) and the 95% CI crossed the line of no effect (line RR = 1). Overall, the RR for penile complications was 0.47 (95% CI 0.28–0.76) and the 95% CI did not cross the line of no effect (line RR = 1). Hence, the risk of penile complications was significantly lower in the non‐transecting group.ConclusionsOur analysis of available evidence indicates that both transecting and non‐transecting urethroplasties, are equal in terms of the recurrence rate. On the other hand, non‐transecting techniques are better in terms of sexual function, causing less penile complications.

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“…Sexual dysfunction such as penile shortening and impaired erection is more common after anastomotic urethroplasty compared to the augmentation techniques. [ 20 ] Augmentation (without transection) of the spongiosal tissue is beneficial as it preserves the blood flow and limits the penile or sexual dysfunction. However, this hypothesis was not supported by any high-level evidence, and only prospective nonrandomized studies were reported to date.…”

Section: Sexual Dysfunction and Penile Complication After Transecting...mentioning

confidence: 99%

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Mandal

2022

Indian J Urol

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Erectile and Ejaculatory Dysfunction After Urethroplasty

Cited by 7 publications

References 61 publications

Male Sexual Dysfunction after Anterior Urethroplasty: Results from a Tertiary Center

Male Sexual Dysfunction after Anterior Urethroplasty: Results from a Tertiary Center

Outcomes of transecting versus non‐transecting urethroplasty for bulbar urethral stricture: a meta‐analysis

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