Prospective analysis of ejaculatory function after anterior urethral reconstruction

Area of Science:

• Urology
• Sexual Health
• Reconstructive Surgery

Background:

• Urethral reconstruction can relieve obstruction but may affect ejaculatory function due to potential disruption of the bulbocavernosus muscle.
• Evaluating the impact of urethroplasty on ejaculatory outcomes is crucial for patient counseling and surgical decision-making.

Purpose of the Study:

• To prospectively assess the effects of anterior urethroplasty on ejaculatory function in men.
• To determine if urethral reconstruction improves or worsens ejaculatory outcomes.

Main Methods:

• Prospective evaluation of 43 men undergoing anterior urethroplasty.
• Utilized the ejaculatory function component of the Male Sexual Health Questionnaire (MSHQ) preoperatively and postoperatively.
• Defined improved/decreased ejaculation based on a 5-point change in MSHQ score.

Main Results:

• Overall ejaculatory scores showed no significant change post-surgery (p=0.17).
• Men with poor preoperative ejaculatory function demonstrated significant improvement (p=0.01).
• Ejaculatory vigor and volume did not change significantly; 70% had stable function, 19% improved, and 11% worsened.

Conclusions:

• Anterior urethroplasty has a minimal overall effect on ejaculatory function as measured by the MSHQ.
• Further objective assessments may be needed to fully understand urethroplasty's impact on ejaculation.