Objective: To evaluate erectile function (EF) after anastomotic (AU) vs substitutional urethroplasty
(SU) for bulbar urethral stricture.
Patients and methods: This was a prospective comparative non-randomised clinical study
conducted in the Department of Urology, Benha University Hospital, between September 2015
and September 2018, involving 34 male patients with urethral stricture. Preoperatively, all the
patients completed the International Index of Erectile Function (IIEF)-15 (EF Domain) to establish
baseline sexual function. AU was performed in 21 patients and SU in 13. The IIEF-15 (EF
Domain) was administered again at 3- and 6-months postoperatively and compared to the
preoperative results.
Results: A total of 34 patients were included in the study, 21 in the AU group with a stricture
length of ≤3 cm, and 13 in the SU group with a stricture length of >3 cm. All patients were
sexually active preoperatively. In the AU group, seven patients developed erectile dysfunction
(ED) at 3-months postoperatively, with four of them improving during the subsequent
3 months, but three had persistent ED at 6-months postoperatively. In the SU group, two
patients developed ED at 3-months postoperatively and they improved during the subsequent
3 months. In the AU group, the mean IIEF-15 (EF Domain) score was 27.6 preoperatively, which
decreased to 25.6 at 6-months postoperatively; however, this was statistically insignificant
(P = 0.10). While in the SU group, the mean IIEF-15 (EF Domain) score was the same before and
at 6 months after SU at 27.2 (P = 1.0).
Conclusion: At 6-months postoperatively, there was no statistically significant impact of
urethroplasty for bulbar urethral stricture on erectile function.
Abbreviations: AU: anastomotic urethroplasty; ED: erectile dysfunction; EF: erectile function;
IIEF: International Index of Erectile Function; SU: substitutional urethroplasty