Anastomotic Repair versus Free Graft Urethroplasty for Bulbar Strictures: A Focus on the Impact on Sexual Function

• Published in: Advances in Urology 2015-01, Vol.2015 (2015), p.195-201
• Main Authors: Lumen, Nicolaas, François, Philippe, Hoebeke, Piet, Spinoit, A. F., Oosterlinck, W. J., Palminteri, Enzo, Beysens, Matthias, Decaestecker, Karel
• Format: Article
• Language: English
• Subjects: Anastomosis; Clinical Study; Comparative analysis; Obstructions; Surgery; Surgical anastomosis; Ureters; Urinary organs
• ISSN: 1687-6369; 1687-6377
• DOI: 10.1155/2015/912438

Objectives. To evaluate alterations in sexual function and genital sensitivity after anastomotic repair (AR) and free graft urethroplasty (FGU) for bulbar urethral strictures. Methods. Patients treated with AR ( n = 31 ) or FGU ( n = 16 ) were prospectively evaluated before, 6 weeks and 6 months after urethroplasty. Evaluation included International Prostate Symptom Score (IPSS), 5-Item International Index of Erectile Function (IIEF-5), Ejaculation/Orgasm Score (EOS), and 3 questions on genital sensitivity. Results. At 6 weeks, there was a significant decline of IIEF-5 for AR (−4.8; p = 0.005 ), whereas there was no significant change for FGU (+0.9; p = 0.115 ). After 6 months, differences with baseline were not significant overall and among subgroups. At 6 weeks, there was a significant decline in EOS for AR (−1.4; p = 0.022 ). In the FGU group there was no significant change (+0.6; p = 0.12 ). Overall and among subgroups, EOS normalized at 6 months. After 6 weeks and 6 months, respectively, 62.2 and 52% of patients reported alterations in penile sensitivity with no significant differences among subgroups. Conclusions. AR is associated with a transient decline in erectile and ejaculatory function. This was not observed with FGU. Bulbar AR and FGU are likely to alter genital sensitivity.