Introduction: Various urethroplasty techniques are used to treat bulbar urethral stricture. Whether the patient erectile function is affected by open surgery is still controversial.
Purpose: The aim of this study is to evaluate the erectile function after anastomotic versus substitutional urethroplasty for bulbar urethral stricture disease.
Methods: This is a prospective non randomized clinical trial that had been conducted on sixty from October 2015 to May 2018 male patients suffering from bulbar urethral stricture disease to evaluate the effect of anastomotic versus substitutional urethroplasty on erectile function via IIEF-5 erectile function questionnaire and penile Doppler ultrasound assessment that had been done in urology department of Benha university hospitals.
Main Outcome Measures: The incidence of ED after urethroplasty
Results: This study included 60 cases. No significant difference was noticed in patients with bulbar urethral stricture before or after intervention. It seems that the incidence of ED was higher in the bulbar anastomosis group than in substitutional urethroplasty group. Ten patients were excluded because of poor EF, leaving 50 patients for analysis. For the entire cohort, IIEF scores remain unchanged (20.17 versus 20.15; p = 0.97). Nine patients (18 %) developed ED, while 6 (12 %) experienced an improvement in EF. Stricture location was not associated with ED, but patient age ≥50 was associated with a decrease in mean postoperative EF (−2.83 versus +1.81; p = 0.043).
Conclusion: The adverse effect of urethroplasty itself on erectile function is limited, as more patients recover erectile function after urethral reconstruction. For anterior urethroplasty, bulbar anastomosis might not cause a slightly higher incidence of ED than other operations.
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