The impact of anterior urethroplasty on sexual function: A prospective analysis of patient's reported outcome

Background: Urethroplasty is the gold standard treatment for anterior urethral stricture disease. Patient-reported outcome measures have been developed to assess both micturition and sexual function postoperatively.Objectives: Evaluation of the impact of anterior urethroplasty on sexual function.Patients and methods: 100 sexually active men with anterior urethral stricture disease with normal preoperative erectile function who underwent anterior urethroplasty at Urology Department, Qena University Hospital using different urethroplasty techniques from January 2021 to June 2023. All patients were followed up for 6 months using the international index of erectile function (IIEF) (15 questions) and Male Sexual Health Questionnaire (MSHQ-EjD Short Form) .Results: patients were classified into 2 groups: Group (A) (non-transecting urethroplasty) including 38 cases with mean age 40.05 ± 12.48 years and group (B) (transecting urethroplasty) including 54 cases with mean age 42.72 ± 13.72 years, only 8 patients were lost during follow up and there was no stricture recurrence during follow up except for 1 case. Post procedural ED percent was 33.7% subdivided into 9 cases (23.68%) in group A and 22 cases (40.74%) in group B with no significant difference (p= 0.088). post procedural ED was transient in most cases except for 1 case (11.11%) in group A and 4 cases (18.18%) in group B with no statistical significant difference (p= 0.627).Conclusion: Urethroplasty has a minimal effect on sexual function. only bulbar urethral excision and re-anastomosis may cause a higher incidence of ED however the age seems to be the most important variable affecting sexual function.