ABSTRACT
OBJECTIVES: The objectives of this study were to evaluate the effect of single-stage anterior urethroplasty on sexual function by considering age, stricture length, location, and different surgical techniques. Incidence of postoperative sexual dysfunction (SD) and probability of recovery were also highlighted. MATERIALS AND METHODS: A total of 115 patients undergoing anterior urethroplasty from February 2016 to June 2020 were evaluated prospectively. Patients were categorized on the basis of age, location, length of stricture as well as surgical techniques. We evaluated three domains of sexual function (erectile, orgasmic, and overall satisfaction) using the International Index of Erectile Function (IIEF) preoperatively and then after 3 months and 6 months postoperatively in follow-up. Pre- and postoperative IIEF values were compared. RESULTS: The mean age was 41.7 ± 13.9 years. There was a significant decrease in postoperative IIEF score from the preoperative value in older patients (>40 years) along with poor recovery at the 6th month as compared to patients of younger age group (≤40 years). However, there was a significant reduction of sexual function postoperatively in case of longer stricture segment, panurethral stricture, bulbar urethral stricture, dorsal buccal mucosal urethroplasty, and excision-primary anastomosis technique in univariate analysis, but on multivariate analysis, only age was proved to be an independent predictor of de novo SD which was found in a total of 28 patients (24.3%). CONCLUSION: Overall, anterior urethroplasty does not influence postoperative sexual function, whereas only older patients have a poor outcome. Most of the younger patients recover completely by 6 months.
ABSTRACT
OBJECTIVE: To determine the erectile dysfunction (ED), overall sexual function, and risk factors for developing ED after surgical repair of penile fracture. MATERIAL AND METHODS: This was an ambispective observational study conducted from September 2014 to August 2019, which included 68 patients with a clinical diagnosis of penile fracture. The clinical presentation, etiology, and surgical details were recorded. Patients were contacted via telephone and called for follow-up. Their sexual function was objectively recorded using the sexual health inventory for men questionnaire, erection hardness grading scale, and the brief male sexual function inventory (BMSFI). Patients were categorized in 2 groups on the basis of ED. These 2 groups were compared on the basis of preoperative and intraoperative factors to determine the predictors of postoperative ED. RESULTS: The mean age at presentation was 33.64±9.46 (range, 19-54) years. The most common mode of injury was injury during the sexual intercourse (78%). All the patients underwent surgical exploration through subcoronal degloving incision. On follow-up, 7 patients (11.3%) developed ED (mild ED, 5 patients; mild-to-moderate ED, 2 patients). Per BMSFI, 58 (93.5%) patients had no bothersome issues with their sexual life, and they were mostly satisfied. The significant risk factors for ED were age >50 years and bilateral corporal involvement. CONCLUSION: Penile fracture is a true urological emergency, and prompt diagnosis by clinical acumen and emergent surgical exploration provide good functional results with low morbidity. The main predictors of postsurgical ED are increasing age (>50 years) and bilateral corporal involvement.