title: Endourological procedures and sexual dysfunction: a prospective multivariate analysis.
abstract: OBJECTIVE
  To investigate whether endourological interventions are associated with postoperative sexual dysfunction.
  
  
  METHODS
  The study comprises a consecutive and prospective series of patients, referred for endourological procedures. General anaesthesia was used and JJ stents were placed when required. Changes in sexual function, as assessed by the International Index of Erectile Function questionnaire that the participants filled in the day before the procedure and 1 month and up to 3 months afterwards, were analysed.
  
  
  RESULTS
  The study group consisted of 50 men aged (mean ± SD) 45 ± 13 years, of whom 25 underwent ureteroscopy, 9 underwent retrograde intrarenal surgery (RIRS) and 16 underwent combined RIRS and percutaneous nephrolithotomy. JJ stents were postoperatively placed in 33 patients (66%). The study cohort self-reported a significant decrease in erectile function (P= 0.007), intercourse satisfaction (P < 0.001), orgasmic function (P= 0.001), sexual desire (P < 0.001) and overall satisfaction (P= 0.002) at 1 month following endourological procedures. This dysfunction was not related to chronic disease, age, smoking, preoperative or postoperative stenting, type of procedure, operative duration or surgeon expertise. The sexual function of all subjects returned to baseline within 3 months (P < 0.005). Postoperative erectile function in the stented group revealed a negative tendency that did not reach statistical significance.
  
  
  CONCLUSIONS
  Endourological procedures are associated with temporary postoperative sexual dysfunction, which completely recovers within 3 months. The impact of postoperative stenting on sexual function was not significant. These findings contribute to enhanced preoperative patient counselling.
authors.affiliation: Department of Urology, Tel-Aviv Sourasky Medical Center, Israel. mariosofer@hotmail.com
authors.forename: Mario
authors.initials: M
authors.lastname: Sofer
authors.forename: Ravit
authors.initials: R
authors.lastname: Yehiely
authors.forename: Alexander
authors.initials: A
authors.lastname: Greenstein
authors.forename: Yuval
authors.initials: Y
authors.lastname: Bar-Yosef
authors.forename: Haim
authors.initials: H
authors.lastname: Matzkin
authors.forename: Juza
authors.initials: J
authors.lastname: Chen
mesh_terms: D000328:Adult; D000368:Aged; D007172:Erectile Dysfunction / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D011446:Prospective Studies; D020127:Recovery of Function; D020018:Sexual Dysfunctions, Psychological / Q000209:etiology*; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D013521:Urologic Surgical Procedures, Male / Q000009:adverse effects*; D055815:Young Adult