Hosseini Jalil, Soleimanzadeh Ardebili Farzen, Fadavi Behrouz, Haghighatkhah Hamidreza
Infertility and Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Urology, Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Urol J. 2018 Mar 18;15(2):33-37. doi: 10.22037/uj.v0i0.3805.
Although improvements in urological function have been less challenged, concern about andrological problems following urethral stricture surgeries has been growing in recent years. The aim of this study is to evaluate the role of the anastomotic urethroplasty itself on erectile function in patients with posterior urethral injuries.
In this prospective cohort study, patients with urethral strictures referring to Tajrish Hospital during October 2013 to August 2016 for anastomotic urethroplasty, were included. All subjects underwent radiologic studies along with rigid and flexible cystoscopy before surgery. Erectile function was evaluated before surgery (twice, addressing pre-traumatic and pre-operational conditions) and after surgery (3 and 6 months post-operatively) via IIEF-5 erectile function questionnaire and color Doppler ultrasound assessment of penilevasculature.
A total of 65 patients with an average age of 30.6 ± 6.1 years were included. A significant decline was observed in erectile function of patients after the injury based on IIEF-5 questionnaire filled twice separately addressing patient conditions before and after trauma (mean IIEF score 23.15 ± 0.93 to 13.45 ± 5.43, P = .001).There was also a significant difference in erectile function of subjects with pelvic fractures compared to those without pelvic fractures (10.43 ± 3.78 vs. 18.96 ± 3.18 P = .001). Univariate and multivariate analyses showedthat urethroplasty itself does not significantly affect erectile function in patients according to penile color Doppler ultrasonography (peak cystolic velocity at cavernosal arteries before and after surgery: right 26.87 ± 6.93 vs26.16 ± 6.53 respectively and left 27.23 ± 5.21 vs 26.52 ± 4.38 respectively) and IIEF-5 erectile function questionnaire (13.12 ± 5.38 vs. 13.54 ± 5.44; P = .26).
The results of this study showed that urethroplasty does not significantly affect erectile function in patients with urethral strictures. The marginal results showing a negatively affected erectile function in patientswith complex strictures may be attributed to a real impact of the surgery in this subgroup or lower number of these cases in our study.
尽管泌尿外科功能的改善较少受到挑战，但近年来，尿道狭窄手术后男性生殖系统问题引发的关注日益增加。本研究旨在评估吻合性尿道成形术本身对后尿道损伤患者勃起功能的作用。
在这项前瞻性队列研究中，纳入了2013年10月至2016年8月期间因吻合性尿道成形术转诊至塔吉什医院的尿道狭窄患者。所有受试者在手术前均接受了放射学检查以及硬性和软性膀胱镜检查。通过国际勃起功能指数-5（IIEF-5）勃起功能问卷和阴茎血管彩色多普勒超声评估，在手术前（两次，分别针对创伤前和手术前情况）和手术后（术后3个月和6个月）对勃起功能进行评估。
共纳入65例平均年龄为30.6±6.1岁的患者。根据分别针对创伤前后患者情况填写的IIEF-5问卷，受伤后患者的勃起功能出现显著下降（平均IIEF评分从23.15±0.93降至13.45±5.43，P = 0.001）。与无骨盆骨折的患者相比，有骨盆骨折的患者勃起功能也存在显著差异（10.43±3.78对18.96±3.18，P = 0.001）。单因素和多因素分析表明，根据阴茎彩色多普勒超声检查（手术前后海绵体动脉的收缩期峰值速度：右侧分别为26.87±6.93和26.16±6.53，左侧分别为27.23±5.21和26.52±4.38）以及IIEF-5勃起功能问卷（13.12±5.38对13.54±5.44；P = 0.26），尿道成形术本身对患者的勃起功能没有显著影响。
本研究结果表明，尿道成形术对尿道狭窄患者的勃起功能没有显著影响。在复杂狭窄患者中显示勃起功能受到负面影响的边缘结果，可能归因于该亚组手术的实际影响或本研究中此类病例数量较少。
