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The effect of urethral transection on erectile function after anterior urethroplasty

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Abstract

Purpose

To prospectively assess the effect of urethral transection on erectile function after anterior urethroplasty.

Methods

From February 2012 to December 2014, 104 patients were enrolled in a prospective study assessing erectile function (EF) after anterior urethroplasty. Participants completed the International Index of Erectile Function (IIEF) questionnaire preoperatively and 6 months postoperatively. Outcome measures were the incidence of erectile dysfunction (ED) defined by ≥5-point change in EF and mean change in the EF domain. Factors examined were urethral transection, stricture location, patient age and other demographics. Fisher’s exact test, Student’s t test and linear regression were used to evaluate associations when appropriate.

Results

Seventeen patients were excluded because of poor EF, leaving 87 patients for analysis. Twenty-two patients (25.3 %) had urethral transection during urethroplasty, while 65 underwent non-transecting techniques (74.7 %). For the entire cohort, IIEF scores remain unchanged (20.16 versus 20.14; p = 0.98). Eighteen patients (20.7 %) developed ED, while 15 (17.2 %) experienced an improvement in EF. Urethral transection was not associated with ED (p = 0.22) or mean change in EF (−0.8 versus +0.2; p = 0.71). Stricture location was not associated with ED, but patient age ≥50 was associated with a decrease in mean postoperative EF (−2.84 versus +1.85; p = 0.04). On linear regression analysis patient age remained independently associated with adverse change in EF (p = 0.05).

Conclusions

Urethroplasty can result in a decline in erectile function in some patients but overall is associated with minimal change in erectile function. Urethral transection is not associated with adverse change in erectile dysfunction after urethroplasty however, advanced patient age is.

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Acknowledgments

The authors would like to acknowledge the Norther Alberta Urology Foundation for assistance in funding this study.

Author contributions

T Haines contributed to data collection and management, data analysis, manuscript writing; KF Rourke participated in project development, data analysis, manuscript writing.

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Authors and Affiliations

  1. Division of Urology, Department of Surgery, University of Alberta, Edmonton, AB, Canada

    Trevor Haines & Keith F. Rourke

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  1. Trevor Haines
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  2. Keith F. Rourke
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Corresponding author

Correspondence to Keith F. Rourke.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standard

This study has been approved by the local university and regional health ethics research board (HREB) and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. The authors have abided by the statement of ethical standards for manuscripts submitted to World Journal of Urology.

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Haines, T., Rourke, K.F. The effect of urethral transection on erectile function after anterior urethroplasty. World J Urol 35, 839–845 (2017). https://doi.org/10.1007/s00345-016-1926-z

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  • DOI: https://doi.org/10.1007/s00345-016-1926-z

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