Erectile Dysfunction After Anterior Urethroplasty: A Prospective Analysis of Incidence and Probability of Recovery-Single-center Experience

OBJECTIVE To evaluate the incidence and probability of recovery of erectile dysfunction after different types of one-stage urethroplasties for anterior urethral stricture disease. METHODS Seventy-eight men undergoing single-stage anterior urethroplasty from January 1, 2008 to March 31, 2010 were followed prospectively. Patients were divided into 3 groups: group 1 (n = 25)-penile substitution urethroplasty; group 2 (n = 32)-primary excision anastomotic bulbar urethroplasty; and group 3 (n = 21)-bulbar substitution urethroplasty. Patients willing to participate completed the International Index of Erectile Function (IIEF) preoperatively and then on subsequent follow-up visits at 3, 6, 9, 12, and 15 months after urethroplasty. Pre- and post-urethroplasty erectile functions were compared. RESULTS Our mean follow-up period was 15.50 + 2.389 months. The mean age (years) was similar among groups. The mean stricture length (cm) was 4.78 +/- 0.747, 2.95 +/- 0.658, and 6.13 +/- 0.981 in-groups 1, 2, and 3, respectively (P = .001). Mean preoperative IIEF score was 24.60 +/- 2.365 (similar among groups). Erectile dysfunction (ED) was found in 15 (20%) patients: 4/25 (16%), 9/32 (28%), and 2/21 (10%) in groups 1, 2, and 3, respectively. Mean postoperative decline (3 months) in IIEF score was 22.54 +/- 4.823. Overall, the decline was not significant among groups (P = .502.) Recovery of erectile function was seen in 75/78 (96%) men at a mean follow-up time of 5.63 +/- 2.59 months. CONCLUSIONS Anterior urethroplasty has a probability of causing ED in as much as 20% of patients. The type of urethroplasty has no significant effect on ED. Recovery of erectile function occurs within 6 months of urethroplasty. UROLOGY 78: 78-81, 2011. (C) 2011 Published by Elsevier Inc.