Erectile dysfunction in patients with traumatic urethral strictures treated with anastomotic urethroplasty: a...

To investigate factors correlated with erectile dysfunction (ED) in patients with traumatic urethral strictures undergoing end-to-end anastomotic urethroplasty (AU).

Between January 2010 and January 2011, 41 patients with urethral strictures resulting from pelvic fracture urethral distraction defects underwent end-to-end AU. The abridged International Index of Erectile Function (IIEF-5) was used to subjectively assess erectile function at admission and 2 weeks postoperatively.

Pre- and post-injury IIEF-5 scores differed significantly (23.54 ± 1.45 versus 10.02 ± 3.57; p < 0.0001), but pre and postoperative scores did not (10.02 ± 3.57 versus 9.29 ± 4.14; p = 0.1560). Erectile function declined in all patients after injury and was postoperatively unchanged in 56.10%. Pre- and post-injury scores differed significantly in all ages, stricture location and length groups, but did not change postoperatively. Urethral injury resulted in varying degrees of ED. IIEF-5 scores declined significantly postoperatively in patients with mild/mild-moderate ED (13.86 ± 1.88 versus 11.43 ± 3.37; p = 0.0202), but were unchanged in patients with moderate/severe ED. Vascular ED was predominant (63.41%), and erectile function was better in patients with non-vascular ED than in those with arterial/venous ED (15.50 ± 2.08 versus 11.00 ± 2.35, 8.67 ± 3.21; p = 0.0037, p = 0.0183). IIEF-5 scores decreased significantly in patients with non-vascular ED postoperatively (15.50 ± 2.08 versus 10.00 ± 3.83; p = 0.0132), but were unchanged in patients with arterial/venous ED.

Urethral trauma seriously affects erectile function, but subsequent end-to-end AU for urethral strictures has little impact.