Effect Of Surgical Treatment On Erectile Function In Male Patients With Urethral Stricture

BackgroundUrethral stricture is one of the common diseases in urology,include iatrogenic injury,trauma,infection and sclerosing lichen can caused urethral stricture.The clinical manifestations of patients with urethral stricture are often dysuria,and complete urethral atresia occurs in severe cases,resulting in patients unable to urinate.The primary goal of treatment for urethral stricture is to restore the patient’s urination function,In recent years,with the development of surgical methods for urethral stricture,the success rate of urethral repair has been significantly improved,More and more attention has been paid to sexual dysfunction associated with urethral stricture itself or its treatment.This study was conducted to investigate the effect of surgical treatment on erectile function in patients with anterior urethral stricture.ObjectiveTo investigate the effect of surgical treatment and other factors on erectile function in male patients with anterior urethral stricture.MethodsCollected from September 2020 to September 2021 in the Department of Urology of Henan Provincial People’s Hospital,The clinical data of 62 male patients diagnosed with anterior urethral stricture,who were treated by three surgical methods including direct visual internal urethrotomy,end-to-end urethral anastomosis,and graft replacement urethroplasty.Finally according to the inclusion and exclusion criteria,Forty-nine patients who met the criteria were enrolled in this study,all patients were divided into three groups according to surgical methods,Patients were visited before surgery and followed up 3months and 6 months after surgery by outpatient review,telephone and wechat respectively,The international index of erectile function-5（IIEF-5）questionnaire and Erectile hardness score（EHS）questionnaire were completed three times.Compared the scores of the two questionnaire.The effect of surgical method on erectile function was analyzed according to IIEF-5 score,and other risk factors were found.ResultsA total of 49（79.03%）valid questionnaires were collected.The age of 49 patients ranged from 27 to 65 years old,with an average of（48.71±11.55）years old.The length of urethral stricture ranged from 0.5 to 18 cm,with an average of（4.27±5.08）cm.The patients were grouped according to the three surgical methods,including 10 cases（20.4%）of direct visual internal urethrotomy group,21 cases（42.9%）of end-to-end urethroplasty group,and18 cases（36.7%）of graft replacement urethroplasty group.Overall,IIEF-5 scores in the direct visual internal urethrotomy group increased after surgery compared with before surgery,IIef-5 scores of patients in the end-to-end urethral anastomosis group and the graft replacement urethroplasty group were decreased after surgery compared with those before surgery,and there was statistical significance（P < 0.001）;The effect of end-to-end urethral anastomosis and graft replacement urethroplasty on erectile function was most significant3 months after surgery,and recovered 6 months after surgery;End-to-end urethral anastomosis had the most significant effect on erectile function（P = 0.002）;Age and length of urethral stricture had no significant effect on erectile function（P > 0.05）.ConclusionDirect visual internal urethrotomy has little effect on erectile function after surgery,and some patients can improve erectile function after surgery;Erectile function was decreased after end-to-end urethral anastomosis and u graft replacement urethroplasty,but the effect of end-to-end urethral anastomosis was more significant;Age and length of urethral stricture had no effect on erectile function after surgery.