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Number №4, 2022 - page 96-101

Multi-stage operations for anterior urethral strictures: evaluation of sexual function DOI: 10.29188/2222-8543-2022-15-4-96-101

For citation: Kogan M.I., Glukhov V.P., Ilyash A.V., Bugaenko V.A., Mitusov V.V., Sizyakin D.V. Multi-stage operations for anterior urethral strictures: evaluation of sexual function. Experimental and Clinical Urology 2022;15(4):96-101; https://doi.org/10.29188/2222-8543-2022-15-4-96-101
Kogan M.I., Glukhov V.P., Ilyash A.V., Bugaenko V.A., Mitusov V.V., Sizyakin D.V.
Information about authors:
  • Kogan M.I. —Dr. Sc., professor, Honored Scientist of Russian Federation; Head of department of Urology and Human Reproductive Health (with the Pediatric Urology and Andrology Сourse), Rostov State Medical University; Rostov-on-Don, Russia; https://orcid.org/0000‑0002‑1710‑0169
  • Glukhov V.P. – PhD, Associate Professor, Department of Urology and Human Reproductive Health (with the Pediatric Urology and Andrology Сourse), Rostov State Medical University; Rostov-onDon, Russia; https://orcid.org/0000-0002-8486-9357
  • Ilyash A.V. – PhD, Assistent, Department of Urology and Human Reproductive Health (with the Pediatric Urology and Andrology Course), Rostov State Medical University; Rostov-on-Don, Russia; https://orcid.org/0000-0001-8433-8567
  • Bugaenko V.A. – Graduate student, of the Department of Urology and Human Reproductive Health (with the Pediatric Urology and Andrology Course), Rostov State Medical University; Rostov-on-Don, Russia; https://orcid.org/0000-0002-7121-2479
  • Mitusov V.V. – Dr. Sc., Professor; Dept. of Urology and Human Reproductive Health (with the Pediatric Urology and Andrology Сourse), Rostov State Medical University; Rostov-on-Don, Russia; https://orcid.org/0000-0001-7706-8925
  • Sizyakin D.V. – Dr. Sc., professor, of Urology and Human Reproductive Health (with the Pediatric Urology and Andrology course), Rostov State Medical University; Rostov-on-Don, Russia; https://orcid.org/0000-0002-9627-2582
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Introduction. Any sexual dysfunction or complications associated with urethral stricture reconstruction can negatively affect quality of life and patient satisfaction with treatment results, even if the operation is considered 'successful' and urethral patency is restored. According to the literature data, the frequency of erectile dysfunction detected after urethroplasty varies from 0 to 40%. However, most publications are focused on the study of sexual disorders caused bulbar urethral reconstruction and one-stage surgical techniques.

Purpose of the study. To evaluate sexual function in patients undergoing multi-stage urethroplasty.

Materials and methods. The study included 73 men aged 18–84 years who underwent multi-stage urethroplasty for the anterior urethral structures in 2010–2019. Penile strictures were present in 39 (53.4%) patients, bulbar strictures in 7 (9.6%), penile bulbar strictures in 15 (20.5%) and multifocal strictures in 12 (16.4%) cases. The length of the strictures was 7.27 ± 3.26 (2–18) cm. The effect of staged urethral surgery on sexual function was studied using the IIEF-5, MSHQ-EjD, and MSHQ-InS questionnaires. The mean time from surgery to evaluation of sexual function was 67.8 ± 32.3 (14–134) months. Wilcoxon signed rank test, Mann-Whitney U test, and Kruskal-Wallis H test were used to test for differences in preoperative and postoperative values. Differences were considered significant at p < 0.05.

Results. There were no significant changes in the initial indicators of the IIEF-5 questionnaire compared to the postoperative ones (19.67 ± 3.45 (5 – 25) vs 21.73 ± 2.47 (6 – 24) points; the mean difference was (Δ) 2.1, 95% confidence interval (95% CI) 16.1 – 20.2, p = 0.468). The total score of the MSHQ-EjD questionnaire increased from 14.67 ± 3.33 (1 – 28) to 25.41 ± 5.65 (1 – 34) points, the mean difference (Δ) was 10.8, 95% confidence interval (95% CI) – 15.4 – 18.9 (p < 0.001). Similar improvements were observed in the analysis of preoperative and postoperative scores of the MSHQ-InS questionnaire (17.31 ± 4.67 (5 – 30) vs. 24.61 ± 4.13 (8 – 30) points; Δ = 7.2; 95% CI: 15.4 – 18.8, p = 0.036).

Conclusions. Patients who underwent multi-stage urethroplasty have minimal changes in erectile function and significant improvements in ejaculatory function, as well as the expressiveness of sexual satisfaction.

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urethral stricture; anterior urethra; multi-stage urethroplasty; sexual function; erectile dysfunction; ejaculation; satisfaction with sexual intercourse

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