Prospective study of de novo sexual dysfunction after anterior urethroplasty: Causative factors, incidence, and recovery of function – A single-center experience

OBJECTIVES: The objectives of this study were to evaluate the effect of single-stage anterior urethroplasty on sexual function by considering age, stricture length, location, and different surgical techniques. Incidence of postoperative sexual dysfunction (SD) and probability of recovery were also highlighted. MATERIALS AND METHODS: A total of 115 patients undergoing anterior urethroplasty from February 2016 to June 2020 were evaluated prospectively. Patients were categorized on the basis of age, location, length of stricture as well as surgical techniques. We evaluated three domains of sexual function (erectile, orgasmic, and overall satisfaction) using the International Index of Erectile Function (IIEF) preoperatively and then after 3 months and 6 months postoperatively in follow-up. Pre- and postoperative IIEF values were compared. RESULTS: The mean age was 41.7 ± 13.9 years. There was a significant decrease in postoperative IIEF score from the preoperative value in older patients (>40 years) along with poor recovery at the 6(th) month as compared to patients of younger age group (≤40 years). However, there was a significant reduction of sexual function postoperatively in case of longer stricture segment, panurethral stricture, bulbar urethral stricture, dorsal buccal mucosal urethroplasty, and excision-primary anastomosis technique in univariate analysis, but on multivariate analysis, only age was proved to be an independent predictor of de novo SD which was found in a total of 28 patients (24.3%). CONCLUSION: Overall, anterior urethroplasty does not influence postoperative sexual function, whereas only older patients have a poor outcome. Most of the younger patients recover completely by 6 months.