Effect of endourological procedures on erectile function: a prospective cohort study

Many patients offered endourological procedures are concerned about potential sexual dysfunction following endoscopy, and there are scarce published data to support an evidence-based response. We aim to assess possible effects of endourological procedures on sexual activity and erectile function.

Sexually active men undergoing cystoscopy and/or upper tract endourological procedures were enrolled and evaluated using the IIEF-5 score and the IPSS, filled the day before and 10 days and 45-60 days after the procedure. Patients' characteristics (age, chronic medical condition, smoking, and medications) were recorded. The primary outcome was the change in the IIEF-5 score.

One hundred patients aged 24-60 years (mean 37.4) underwent endourological procedures (42 PCNLs, 30 ureteroscopies, 22 retrograde ureteropyelographies ± stenting, and 6 cystolitholapaxies) between January and August 2014. Preoperative IPSS ranged from 0 to 32 (mean [SD] 11.93 [8.64]), while IIEF-5 ranged from 14 to 25 (mean [SD] 21.63 [2.96]), with eight patients in the mild to moderate (12-16) ED range, 31 mild ED (17-21), and 59 no ED (22-25). Following the procedure, the IPSS improved (mean IPSS down from 11.9 to 6.1 at 10 days and 6.2 at 45 days, P < 0.001), while the IIEF remained unchanged [21.6 preoperative to 21.0 at 10 days (P = 0.43) and 21.7 at 45 days (P = 0.81)]. Patients with indwelling ureteric stents (28 patients) had significant LUTS postoperatively with a mean [SD] IPSS of 9.8 [7.2] at 10 days and 11.6 [7.8] at 45 days. The IIEF-5 score was not affected with a mean [SD] of 21.5 [3.3] at 10 days and 21.8 [3.1] at 45 days, compared to 22.0 [3.0] preoperatively (P = 0.44).

Endoscopic procedures did not negatively impact erectile function and sexual activity.