Evaluation of Erectile Dysfunction as a Consequence of Urethroplasty: A Prospective Observational Study

Objective The objective of this study is to evaluate the change in erectile function in patients undergoing urethroplasty for anterior urethral strictures and pelvic fracture urethral injuries (PFUI) and to assess vascular insufficiency as the cause of erectile dysfunction after urethroplasty. Material & Methods For this study, 58 participants were enrolled. Eight patients had progressive perineal urethroplasty (PPU) for pelvic fracture urethral injury (PFUI), while five patients had urethroplasty for anterior urethral stricture (AUS). International Index of Erectile Function (IIEF-5) preoperative and postoperative scores were examined at three, six, nine, and 12 months. For every patient having an IIEF-5 score below 22, pharmacological color Doppler ultrasonography (CDUS) of penis was performed both before and after surgery at six months.  Results Thirty men reported some degree of preoperative erectile dysfunction among patients who suffered from AUS. Postoperatively, at three months, 33 men reported erectile dysfunction, while after 12 months, 28 men reported erectile dysfunction. Additionally, there wasn't any discernible change in IIEF ratings after a 12-month follow-up period (p-value 1.000). After three months, the mean IIEF score among PFUI patients significantly decreased to 16.75 ± 2.82 (p-value 0.002), but after twelve months, the IIEF score did not significantly alter. There was no discernible change in blood flow on postoperative colour Doppler ultrasonography. Conclusions Urethroplasty negatively alters erectile function during the early postoperative period. Still, after six to 12 months, most patients recover their erectile function to preoperative status. De novo erectile dysfunction is very rare post-urethroplasty. Following these operations, there aren't many vascular events that could cause erectile dysfunction.