| Objective: To evaluate the effects of urethral reconstructive surgery on erectile function and sexual life quality.Methods: There were 517 patients who were underwent urethroplasty for urethral stricture disease in our department from January 2003 to January 2007. We got 326 patients according to our research demand and analyzed retrospectively their clinical data. The 326 male patients were followed up in order to evaluate the effects of urethral reconstructive surgery on erectile function and sexual life quality.Results: 172 valid data points were collected. The mean follow-up time was 28.5 months. The mean age and stricture length was 41.8±12.0 years, 0.5 ~ 20(3.7±3.9)cm. We used 4 different surgery methods which were internal urethrotomy (56 pts), posterior anastomotic urethroplasty through perinaeum (57 pts), posterior anastomotic urethroplasty through symphysis pubis (7 pts), substitution urethroplasty with autologous tisse (52 pts). The quality of life and maximum uroflomentry were improved obviously than pre-surgery (P < 0.05). The mean IIEF-5 scores (P=0.002) and sexual life quality scores (P=0.026) were statistically significantly reduced after surgery. We divided the patients into groups. The IIEF-5 scores were decreased than pre-surgery in four groups which were the patients less than 50 years old, the patients with 2-5cm-length stricture, the patients with posterior urethra stricture, and the patients underwent posterior anastomotic urethroplasty through perinaeum. And the recurrence of urethral stricture influenced the erectile function too, P<0.05. There were 56(32.6%) patients with erectile dysfunction before surgery and 88(51.2%) patients after surgery. 38 patients (32.8%) of the 116 normal patients reported ED after surgery. 6 patients (10.7%) of the 56 patients with ED reported normal after surgery. The SLQQ scores of 3 months and 6 months after surgery were 40.8±33.9,49.6±33.1,P<0.05,The IIEF-5 scores of 3 months and 6 months after surgery were 14.5±10.9,16.0±10.2,P<0.05.Conclusion: Reconstructive surgery for urethral stricture disease will degrade the patients'erectile function and sexual life quality. All of the location of urethral stricture, surgery method, and post-surgical urethral stricture recurrence influence erectile function and sexual life quality after urethral reconstructive surgery. The two factors which are posterior urethra stricture and posterior anastomotic urethroplasty through perinaeum improve post-surgery erectile function rate more possibly. Erectile function and sexual life quality improve gradually with time growing. |
