PL 03. Male sexual function before and after urethral stricture surgery
Urethral stricture is the one of most common diseases of urological surgery. The causes of urethral strictures such as pelvic fracture would lead to poor outcome of patients' sexual function. The intervention of urethral stricture is main reconstructive surgery, and it may damage some structure and make negative impaction on sexual function in some extent. At present, most researches of urethral stricture reconstruction are more emphasized on the improvement of urination function, less has been reported regarding posterior effect of surgery on sexual function. To investigate the sexual function in men with urethral stricture before and after the surgical treatments, evaluate these effects of the different treatments on sexual function, we performed a retrospective investigation of the effects of urethral reconstructive surgery on urethral stricture patients' sexual function.
From January 2005 to June 2007, men with urethral stricture and undergone surgical treatment in West China Hospital were enrolled. The American Urological Association symptom index and the International Index of Erectile Function (IIEF) were used to evaluate the life quality and the sexual function by mail, telephone or interview. SPSS13.0 software was used to analyze the data.
A total of 91 men with an average age of 51.1 years (range 18 to 78) completed the study. The average follow-up duration was 16.6 months (range 5 to 35). Of these men, 24 (26.4%) were treated by end to end anastomosis urethroplasty, 13 (14.3%) were treated by graft onlay urethroplasty, the others were treated by internal urethrotomy.
There were no statistical IIEF score difference among 3 different surgery groups, and the erectile function (EF), orgasmic function (OF), sexual desire (SD), intercourse satisfaction (IS), and overall satisfaction scores also had not significant difference between 3 surgery groups.
The difference of IIEF was statistically no significant between the pre- and post-operation in 18-39 and 40-59 years old groups respectively (P>0.05). The erectile function score in 60-78 years old group was significantly lowered after the operation (9.67 vs. 8.39, P=0.04). The EF, OF, SD scores of the men with complications were different from the men's without complications, and the difference was significant. The differences of stricture length, and stricture location among these groups were insignificant.
There was no significant difference of IIEFs among patients of DVIU group, anastomotic urethroplasty group and graft onlay urethroplasty group respectively.
The declined erecti le function was more possibly occurred in patient with recurrence of urethral stricture and surgical complication. This proved that successfully cure the urethral stricture might the main contribution of the sexual function improvement, and was the reason of 23.1% patients' postoperative sexual function were improved. In our study, the IPSS score of patients with postoperative erectile function declined was higher than those postoperative erectile function unchanged or increased (P=0.009). The postoperative urination functional status of patients was directly related to their postoperative erectile function.
In our study, there was no significant difference of IIEF before and after urethral stricture surgery.
The declined erectile function was more possibly occurred in patient with recurrence of urethral stricture and surgical complication. The postoperative urination functional status of patients was directly related to their postoperative erectile function. There was no sufficient evidence in support of the urethral stricture length would make obvious negative impact on patients' postoperative sexual function.
