Erectile and voiding function outcomes after buccal mucosa graft urethroplasty for long-segment bulbar urethral stricture: ventral versus dorsal onlay technique

Shalkamy, Osama; Elatreisy, Adel; Salih, Elsayed; Safar, Omar; Aljubran, Abdulkareem; Abouelgreed, Tamer A.; Khogeer, Abdulghani; Ibrahim, A.

doi:10.1007/s00345-022-04220-y

Cited by 2 publications

(1 citation statement)

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“…In BMG (buccal mucosal graft) Bulbar urethroplasty, transient ED could rely on transient neurapraxia, and blood supply alteration that revascularizes in the healing process. However, permanent ED could be explained by cavernous and perineal nerve injury and bulbar artery flow disruption [ 2 ]. Al- Qudah and Santucci reported the superiority of BMG bulbar urethroplasty over the anastomotic repair with a better functional outcome and no reported sexual dysfunction compared to 18% after anastomotic repair [ 3 ]; also, many studies reported a variety of erectile and ejaculatory dysfunctions following transecting anastomotic urethroplasty [ 1 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Erectile function after different techniques of bulbar urethroplasty: does urethral transection make a difference?

Shalkamy,

Elsalhy,

Alghamdi

et al. 2023

BMC Urol

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Purpose We aimed to compare the impact of urethral transection after different techniques of bulbar urethroplasty on erectile function outcome. Materials and methods We retrospectively reviewed the records for 245 patients who underwent different urethroplasty techniques for bulbar urethral stricture between February 2013 and January 2021. The comparison between the transecting and non-transecting cohorts included patients’ demographics, clinicopathological features of the urethral stricture, post-urethroplasty erectile function, and success of urethroplasty. Outcomes were erectile function status verified by IIEF5-15 score at preoperative, three months, and 12 months post-surgery. We defined Post-urethroplasty ED as a decrease of 5 points or more. Results The urethroplasty success rate of the entire cohort was 86.9% after a mean follow-up of 45.59 ± 21 months. Out of 245 patients, 18 (7.3%) experienced 90-day complications. Transecting bulbar urethroplasty techniques were performed in 74 patients (30.2%), while non-transecting techniques were performed in 171 patients (69.8%). there were no differences between the cohorts regarding urethroplasty success (87.8% Vs. 86.5%, Mantel-Cox test p = 0.93) or postoperative complications (8.1% Vs. 7%, p = 0.73). Transient ED was evident in the transecting cohort as reported in 8.1% compared to 2.9% for the non-transecting (p = 0.07).Still, but de novo permanent ED was comparable (4.1% Vs. 2.9%, p = 0.65), for transecting and non-transecting, respectively. Conclusions Unfortunately, some patients who undergo transecting techniques of bulbar urethroplasty experience transient erectile dysfunction that can improve within the first post- urethroplasty year; however, de novo permanent erectile dysfunction is uncommon after different techniques of bulbar urethroplasty and is not predisposed by urethral transection.

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