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Association Between Ejaculatory Dysfunction and Post-Void Dribbling After Urethroplasty.
Katherine M Theisen1, Ayman Soubra2, Shawn Grove2
1Mayo Clinic Rochester, MN.
Urology
|April 26, 2021
Summary
Ejaculatory dysfunction and post-void dribbling are common after urethroplasty and significantly associated, suggesting a shared cause. Further research is needed to understand and prevent these common post-surgical symptoms.
Area of Science:
- Urology
- Male Sexual Health
- Surgical Outcomes
Background:
- Anterior urethroplasty is a surgical treatment for urethral strictures.
- Ejaculatory dysfunction (EjD) and post-void dribbling (PVD) are potential complications following urethroplasty.
- The underlying causes and associations between these specific post-operative symptoms are not fully understood.
Purpose of the Study:
- To investigate the association between ejaculatory dysfunction (EjD) and post-void dribbling (PVD) after anterior urethroplasty.
- To provide evidence for a potential common etiology underlying both EjD and PVD.
- To compare the occurrence of EjD and PVD based on surgical techniques.
Main Methods:
- A prospectively maintained database of patients undergoing first-time anterior urethroplasty was reviewed.
- EjD was assessed using the Male Sexual Health Questionnaire (MSHQ).
- PVD was assessed using the Urethral Stricture Surgery Patient-Reported Outcome Measure (USS-PROM).
- Symptom frequencies were compared between penile and bulbar repairs, and anastomotic versus augmentation bulbar repairs using chi-square tests.
Main Results:
- A total of 728 men were included in the study.
- Postoperative EjD and PVD were highly prevalent, occurring in 67% and 66% of patients, respectively.
- A significant association was found between EjD and PVD across the entire cohort (p<0.0001) and in specific subgroups (penile repairs, bulbar repairs, bulbar anastomotic repairs).
- PVD rates were higher after bulbar augmentation repairs compared to bulbar anastomotic repairs (70% vs. 52%, p=0.0001).
Conclusions:
- EjD and PVD are significantly associated after anterior urethroplasty, supporting a common underlying etiology.
- The high incidence of these symptoms after penile and anastomotic repairs challenges certain proposed etiological mechanisms.
- Further research is required to elucidate the exact causes and develop strategies for symptom prevention.
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