Evaluation of erectile function after urethral reconstruction: a prospective study

Abstract

We conducted a prospective study of erectile dysfunction (ED) after urethral reconstructive surgery, using the 5-item International Index of Erectile Function (IIEF-5), the Sexual Life Quality Questionnaire (SLQQ) and the Quality of Life Questionnaire (QoLQ). Between January 2003 and July 2007, 125 male patients with urethral strictures underwent urethroplasty, and pre-and post-surgery erectile function was assessed using these three questionnaires. A formula to predict the probability of ED after urethroplasty was derived. At 3 months postoperatively, there was a significant decrease in IIEF-5 (16.57 ± 7.98) and SLQQ scores (28.71 ± 14.84) compared with pre-operative scores (P < 0.05). However, the IIEF-5 scores rebounded at 6 months post-operatively (17.22 ± 8.41). Logistical regression analysis showed that the location of the urethral stricture, the recurrence of strictures and the choice of surgical technique were predictive of the post-operative occurrence of ED. This study identified the clinical risk factors for ED after urethroplasty. Posterior urethral stricture and end-to-end anastomosis were found to have a strong relationship with erectile function. The logistical model derived in this study may be applied to clinical decision algorithms for patients with urethral strictures.

Assessment of the short-term functional outcome after urethroplasty: a prospective analysis

“…The pelvic trauma itself can damage the cavernosal nerves and/or to the blood supply of the corpora cavernosa (branches of the A.pudenda interna) (20). The difficult dissection at the membranous urethra during posterior urethroplasty can further damage the neurovascular structures related to the corpora cavernosa (18), although others have observed spontaneous recovery of erectile function after posterior urethroplasty (21,22).…”

Erectile dysfunction in urethral stricture and pelvic fracture urethral injury patients: diagnosis, treatment, and outcomes

“…Baseline and post-operative IIEF-5 scores in both anterior and posterior urethroplasty have been studied. There was significant decrease in IIEF-5 scores at 3 months after posterior urethroplasty (17.05 vs. 9.37, p < 0.05), which was not observed in anterior urethroplasty (Xie et al, 2009). However, improvement of erectile function occurred at 6 months after posterior urethroplasty, especially in younger patients (<40 years) (Xie et al, 2009).…”

“…There was significant decrease in IIEF-5 scores at 3 months after posterior urethroplasty (17.05 vs. 9.37, p < 0.05), which was not observed in anterior urethroplasty (Xie et al, 2009). However, improvement of erectile function occurred at 6 months after posterior urethroplasty, especially in younger patients (<40 years) (Xie et al, 2009). Another study reported 40% of patients suffered from ED after pelvic fracture with a posterior urethral injury.…”

Urethroplasty; Wide Range of Therapeutic Indications and Surgical Techniques

“…If the anastomotic urethroplasty is possible it is the procedure of choice having a success rate of approximately 90% at the intermediate follow-up [52,53]. In the patients with a 2-5 cm stricture undergoing an anastomotic procedure the risk erectile dysfunction is increased [54]. A prospective study of erectile function posturethroplasty showed anastomotic procedure in the bulbar urethra resulted in a significant impairment of erectile function initially which improved in the majority of cases.…”