# Evaluation of Erectile Dysfunction as a Consequence of Urethroplasty: A Prospective Observational Study

## TL;DR

This study finds that urethroplasty temporarily affects erectile function, but most patients recover within a year.

## Contribution

The study provides new insights into the short- and long-term effects of urethroplasty on erectile function.

## Key findings

- Erectile dysfunction increased immediately after surgery but improved over time.
- Most patients returned to preoperative erectile function within 12 months.
- Vascular insufficiency was not a common cause of postoperative erectile dysfunction.

## Abstract

Objective

The objective of this study is to evaluate the change in erectile function in patients undergoing urethroplasty for anterior urethral strictures and pelvic fracture urethral injuries (PFUI) and to assess vascular insufficiency as the cause of erectile dysfunction after urethroplasty.

Material & Methods

For this study, 58 participants were enrolled. Eight patients had progressive perineal urethroplasty (PPU) for pelvic fracture urethral injury (PFUI), while five patients had urethroplasty for anterior urethral stricture (AUS). International Index of Erectile Function (IIEF-5) preoperative and postoperative scores were examined at three, six, nine, and 12 months. For every patient having an IIEF-5 score below 22, pharmacological color Doppler ultrasonography (CDUS) of penis was performed both before and after surgery at six months.

Results

Thirty men reported some degree of preoperative erectile dysfunction among patients who suffered from AUS. Postoperatively, at three months, 33 men reported erectile dysfunction, while after 12 months, 28 men reported erectile dysfunction. Additionally, there wasn’t any discernible change in IIEF ratings after a 12-month follow-up period (p-value 1.000). After three months, the mean IIEF score among PFUI patients significantly decreased to 16.75 ± 2.82 (p-value 0.002), but after twelve months, the IIEF score did not significantly alter. There was no discernible change in blood flow on postoperative colour Doppler ultrasonography.

Conclusions

Urethroplasty negatively alters erectile function during the early postoperative period. Still, after six to 12 months, most patients recover their erectile function to preoperative status. De novo erectile dysfunction is very rare post-urethroplasty. Following these operations, there aren't many vascular events that could cause erectile dysfunction.