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
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
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
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.