title: Erectile dysfunction in patients with traumatic urethral strictures treated with anastomotic urethroplasty: a single-factor analysis.
abstract: BACKGROUND
  To investigate factors correlated with erectile dysfunction (ED) in patients with traumatic urethral strictures undergoing end-to-end anastomotic urethroplasty (AU).
  
  
  METHODS
  Between January 2010 and January 2011, 41 patients with urethral strictures resulting from pelvic fracture urethral distraction defects underwent end-to-end AU.  The abridged International Index of Erectile Function (IIEF-5) was used to subjectively assess erectile function at admission and 2 weeks postoperatively.
  
  
  RESULTS
  Pre- and post-injury IIEF-5 scores differed significantly (23.54 ± 1.45 versus 10.02 ± 3.57; p < 0.0001), but pre and postoperative scores did not (10.02 ± 3.57 versus 9.29 ± 4.14; p = 0.1560).  Erectile function declined in all patients after injury and was postoperatively unchanged in 56.10%.  Pre- and post-injury scores differed significantly in all ages, stricture location and length groups, but did not change postoperatively.  Urethral injury resulted in varying degrees of ED.  IIEF-5 scores declined significantly postoperatively in patients with mild/mild-moderate ED (13.86 ± 1.88 versus 11.43 ± 3.37; p = 0.0202), but were unchanged in patients with moderate/severe ED.  Vascular ED was predominant (63.41%), and erectile function was better in patients with non-vascular ED than in those with arterial/venous ED (15.50 ± 2.08 versus 11.00 ± 2.35, 8.67 ± 3.21; p = 0.0037, p = 0.0183).  IIEF-5 scores decreased significantly in patients with non-vascular ED postoperatively (15.50 ± 2.08 versus 10.00 ± 3.83; p = 0.0132), but were unchanged in patients with arterial/venous ED.
  
  
  CONCLUSIONS
  Urethral trauma seriously affects erectile function, but subsequent end-to-end AU for urethral strictures has little impact.
authors.affiliation: Department of Urology, Shanghai 6th Hospital Affiliated with Shanghai Jiaotong University-Shanghai Jiaotong University Urethral Disease, Diagnosis and Treatment Center, Shanghai, PR China.
authors.forename: Chen-Ye
authors.initials: CY
authors.lastname: Tang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Fu
authors.forename: Ren-Jie
authors.initials: RJ
authors.lastname: Cui
authors.forename: Xian-Jun
authors.initials: XJ
authors.lastname: Sun
mesh_terms: D000293:Adolescent; D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects / Q000379:methods; D015331:Cohort Studies; D007172:Erectile Dysfunction / Q000209:etiology* / Q000503:physiopathology / Q000601:surgery*; D005500:Follow-Up Studies; D050723:Fractures, Bone / Q000150:complications / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000293:injuries; D020127:Recovery of Function; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome; D014525:Urethral Stricture / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D014567:Urography / Q000379:methods; D013520:Urologic Surgical Procedures / Q000379:methods*; D055815:Young Adult