We conducted a prospective study of erectile dysfunction(ED)after urethral reconstructive surgery,using the 5-item International Index of Erectile Function(IIEF-5),the Sexual Life Quality Questionnaire(SLQQ)and the Qu...We conducted a prospective study of erectile dysfunction(ED)after urethral reconstructive surgery,using the 5-item International Index of Erectile Function(IIEF-5),the Sexual Life Quality Questionnaire(SLQQ)and the Quality of Life Questionnaire(QoLQ).Between January 2003 and July 2007,125 male patients with urethral strictures underwent urethroplasty,and pre-and post-surgery erectile function was assessed using these three questionnaires.A formula to predict the probability of ED after urethroplasty was derived.At 3 months post-operatively,there was a significant decrease in IIEF-5(16.57±7.98)and SLQQ scores(28.71±14.84)compared with pre-operative scores(P<0.05).However,the IIEF-5 scores rebounded at 6 months post-operatively(17.22±8.41).Logistical regression analysis showed that the location of the urethral stricture,the recurrence of strictures and the choice of surgical technique were predictive of the post-operative occurrence of ED.This study identified the clinical risk factors for ED after urethroplasty.Posterior urethral stricture and end-to-end anastomosis were found to have a strong relationship with erectile function.The logistical model derived in this study may be applied to clinical decision algorithms for patients with urethral strictures.展开更多
Advances in urogenital plastic surgical tissue transfer techniques have enabled urethral reconstruction surgery to become the new gold-standard for treatment of refractory urethral stricture disease. Questions remain,...Advances in urogenital plastic surgical tissue transfer techniques have enabled urethral reconstruction surgery to become the new gold-standard for treatment of refractory urethral stricture disease. Questions remain, however, regarding the long-term implications on sexual function after major genital reconstructive surgery. In this article, we review the pathologic features of urethral stricture disease and urologic trauma that may affect erectile function （EF） and assess the impact of various specific contemporary urethroplasty surgical techniques on male sexual function.展开更多
The aim of this study was to evaluate erectile function in patients with panurethral stricture after urethral reconstruction. Totally, 65 patients were enrolled. Different urethral reconstructions were performed accor...The aim of this study was to evaluate erectile function in patients with panurethral stricture after urethral reconstruction. Totally, 65 patients were enrolled. Different urethral reconstructions were performed according to the details of urethral strictures. The erectile function was evaluated before and after surgery. The length and location of stricture and duration from initial diagnosis to operation were recorded. The International Index of Erectile Function-5 （IIEF-5） scores, the quality of life （QoL） scores and the maximal flow rate were obtained before and 3, 6, and 12 months after surgery. A significant improvement in QoL and maximal flow rate was observed 3, 6, and 12 months after surgery compared with those observed before surgery （P 〈 0.05）. An impairment of erectile function was observed in patients with multi-site stricture 3 months after surgery （P 〈 0.05）. Subsequently, these patients recovered 6 and 12 months after surgery. Three months after surgery, the IIEF-5 scores in patients with anterior urethral stricture were higher than those with multi-site stricture. Similar results were observed 6 and 12 months after surgery. No significant difference in age or duration from initial diagnosis to final operation was observed between patients with erectile dysfunction after surgery and patients with normal erectile function. However, a linear regressive relationship was detected between IIEF-5 scores and location of urethral stricture. Surgical reconstruction for treating panurethral strictures has limited effects on erectile function. The location of the stricture, particularly when extended to posterior urethra, was found to be associated with erectile function after surgery.展开更多
Background: Posterior urethral injury usually occurs in male patients with pelvic fractures. Posterior urethral injuries are associated with considerable morbidity including urinary incontinence, erectile dysfunction ...Background: Posterior urethral injury usually occurs in male patients with pelvic fractures. Posterior urethral injuries are associated with considerable morbidity including urinary incontinence, erectile dysfunction and urethral stricture. Objective: To compare the outcomes between early primary endoscopic realignment and delayed reconstruction in the management of male patients of posterior urethral injury. Methodology: This prospective study was conducted in the department of urology and department of casualty, Dhaka Medical College Hospital, Dhaka, Bangladesh from July 2015 to June 2017 among 50 male patients with posterior urethral injury. Fifty patients were randomly allocated into two groups;the group A consisted of 24 patients underwent early primary endoscopic realignment within 10 days after posterior urethral injury and the group B consisted of 26 patients underwent delayed reconstruction in form of anastomotic urethroplasty after 3 months. All patients were followed up at 3rd, 6th and 9th month after the procedure. Outcome variables were post-operative urethral stricture, urinary incontinence and erectile dysfunction. Data were analyzed and compared by statistical tests. Results: The mean (±SD) age of the study patients was almost similar between the groups (28.8 ± 8.4 vs. 27.4 ± 7.2 years, p = 0.486). In group A, 83.33% patients developed postoperative urethral stricture, none of them developed urinary incontinence and 20.83% developed erectile dysfunction;On the other hand, in group B, these rates were 38.46%, 23.07% and 38.46% respectively. Postoperative urethral stricture formation was significantly higher in Group A (p = 0.0012) but urinary incontinence and erectile dysfunction rates were significantly higher in Group B (p = 0.018 and p = 0.042 respectively). Conclusion: Early primary endoscopic realignment is better than delayed reconstruction in the management of male patients with posterior urethral injury. It provides less postoperative complications like urinary incontinence and erectile dysfunction, though postoperative urethral stricture formation is higher but amenable to be corrected endoscopically.展开更多
文摘We conducted a prospective study of erectile dysfunction(ED)after urethral reconstructive surgery,using the 5-item International Index of Erectile Function(IIEF-5),the Sexual Life Quality Questionnaire(SLQQ)and the Quality of Life Questionnaire(QoLQ).Between January 2003 and July 2007,125 male patients with urethral strictures underwent urethroplasty,and pre-and post-surgery erectile function was assessed using these three questionnaires.A formula to predict the probability of ED after urethroplasty was derived.At 3 months post-operatively,there was a significant decrease in IIEF-5(16.57±7.98)and SLQQ scores(28.71±14.84)compared with pre-operative scores(P<0.05).However,the IIEF-5 scores rebounded at 6 months post-operatively(17.22±8.41).Logistical regression analysis showed that the location of the urethral stricture,the recurrence of strictures and the choice of surgical technique were predictive of the post-operative occurrence of ED.This study identified the clinical risk factors for ED after urethroplasty.Posterior urethral stricture and end-to-end anastomosis were found to have a strong relationship with erectile function.The logistical model derived in this study may be applied to clinical decision algorithms for patients with urethral strictures.
文摘Advances in urogenital plastic surgical tissue transfer techniques have enabled urethral reconstruction surgery to become the new gold-standard for treatment of refractory urethral stricture disease. Questions remain, however, regarding the long-term implications on sexual function after major genital reconstructive surgery. In this article, we review the pathologic features of urethral stricture disease and urologic trauma that may affect erectile function （EF） and assess the impact of various specific contemporary urethroplasty surgical techniques on male sexual function.
文摘The aim of this study was to evaluate erectile function in patients with panurethral stricture after urethral reconstruction. Totally, 65 patients were enrolled. Different urethral reconstructions were performed according to the details of urethral strictures. The erectile function was evaluated before and after surgery. The length and location of stricture and duration from initial diagnosis to operation were recorded. The International Index of Erectile Function-5 （IIEF-5） scores, the quality of life （QoL） scores and the maximal flow rate were obtained before and 3, 6, and 12 months after surgery. A significant improvement in QoL and maximal flow rate was observed 3, 6, and 12 months after surgery compared with those observed before surgery （P 〈 0.05）. An impairment of erectile function was observed in patients with multi-site stricture 3 months after surgery （P 〈 0.05）. Subsequently, these patients recovered 6 and 12 months after surgery. Three months after surgery, the IIEF-5 scores in patients with anterior urethral stricture were higher than those with multi-site stricture. Similar results were observed 6 and 12 months after surgery. No significant difference in age or duration from initial diagnosis to final operation was observed between patients with erectile dysfunction after surgery and patients with normal erectile function. However, a linear regressive relationship was detected between IIEF-5 scores and location of urethral stricture. Surgical reconstruction for treating panurethral strictures has limited effects on erectile function. The location of the stricture, particularly when extended to posterior urethra, was found to be associated with erectile function after surgery.
文摘Background: Posterior urethral injury usually occurs in male patients with pelvic fractures. Posterior urethral injuries are associated with considerable morbidity including urinary incontinence, erectile dysfunction and urethral stricture. Objective: To compare the outcomes between early primary endoscopic realignment and delayed reconstruction in the management of male patients of posterior urethral injury. Methodology: This prospective study was conducted in the department of urology and department of casualty, Dhaka Medical College Hospital, Dhaka, Bangladesh from July 2015 to June 2017 among 50 male patients with posterior urethral injury. Fifty patients were randomly allocated into two groups;the group A consisted of 24 patients underwent early primary endoscopic realignment within 10 days after posterior urethral injury and the group B consisted of 26 patients underwent delayed reconstruction in form of anastomotic urethroplasty after 3 months. All patients were followed up at 3rd, 6th and 9th month after the procedure. Outcome variables were post-operative urethral stricture, urinary incontinence and erectile dysfunction. Data were analyzed and compared by statistical tests. Results: The mean (±SD) age of the study patients was almost similar between the groups (28.8 ± 8.4 vs. 27.4 ± 7.2 years, p = 0.486). In group A, 83.33% patients developed postoperative urethral stricture, none of them developed urinary incontinence and 20.83% developed erectile dysfunction;On the other hand, in group B, these rates were 38.46%, 23.07% and 38.46% respectively. Postoperative urethral stricture formation was significantly higher in Group A (p = 0.0012) but urinary incontinence and erectile dysfunction rates were significantly higher in Group B (p = 0.018 and p = 0.042 respectively). Conclusion: Early primary endoscopic realignment is better than delayed reconstruction in the management of male patients with posterior urethral injury. It provides less postoperative complications like urinary incontinence and erectile dysfunction, though postoperative urethral stricture formation is higher but amenable to be corrected endoscopically.
