Erectile function, sexual drive, and ejaculatory function after reconstructive surgery for anterior urethral stricture disease

OBLECTIVE To evaluate the effect of urethral reconstructive surgery on sexual drive, erectile function and ejaculation. PATIENTS AND METHODS The study group consisted of 52 men with a median (range) age of 44 (18-79) years who underwent 59 urethral reconstructive procedures for anterior urethral stricture disease between 2001 and 2004. We evaluated sexual functioning using the O'Leary Brief Male Sexual Function Inventory (BMSFI) before and after surgery. RESULTS The mean (SD) follow-up was 22.3 (14.8) months. The mean BMSFI scores were only statistically significantly different for an improvement in ejaculation after surgery (P = 0.04). When separated by age, only the men aged 50-59 years reported decreased erectile function after surgery (P < 0.001) and only those aged < 40-49 years reported an improvement in ejaculatory function (P = 0.05). Men at < 1 year after surgery reported lower sexual drive (P = 0.025) and erectile function (P = 0.05) than men with longer periods of recovery. CONCLUSION The BMFSI is useful for evaluating sexual function after urethroplasty. Overall, the men did not report a decline in erectile function or sexual drive after surgery; however, older men might have a higher incidence of erectile dysfunction after surgery. Erectile function might recover with time. Younger men had the most pronounced improvement in ejaculatory function, but further studies are necessary to evaluate the clinical significance of this.