title: Patient-Reported Sexual Function After Staged Penile Urethroplasty.
abstract: OBJECTIVE
  To evaluate sexual function after staged penile urethroplasty with oral mucosal graft (OMG).
  
  
  METHODS
  We identified men with completed staged penile urethroplasty with OMG from the Trauma and Urologic Reconstruction Network of Surgeons database between January 1, 2010 and May 1, 2014. Our primary outcome was change in total Sexual Health Inventory for Men (SHIM) and total Male Sexual Health Questionnaire Ejaculatory Domain (MSHQ-EjD) Short Form at baseline vs after the second stage of the procedure. Second, we assessed subjective changes in penile curvature, length, and sensation.
  
  
  RESULTS
  Thirty-three patients were included with a mean age of 45 years and mean body mass index of 27.6 kg/m(2). Urethral strictures arose from failed hypospadias repair in 52% and lichen sclerosus in 27%. Fifty-two percent of patients reported a previous urethroplasty. The median follow-up time between the second stage procedure and postoperative questionnaires was 6.3 months (interquartile range: 3.5-13.3). There was no significant change in the total SHIM (Δ0.64, 95% confidence interval [CI]: -3.00∼1.72) and MSHQ-EjD (Δ1.55, 95% CI: -1.53∼4.63) scores preoperatively vs postoperatively. In addition, 32% reported improved and 52% no change in satisfaction with sexual intercourse (SHIM Q5). Forty percent of patients reported reduced and 45% no change in bother with ejaculation after surgery (MSHQ-EjD Q4). Men reported new penile curvature (23%), loss of penile length (55%), and altered penile sensitivity (45%) after surgery.
  
  
  CONCLUSIONS
  Patients undergoing staged penile urethroplasty with OMG are likely to have minimal changes in erectile and ejaculatory function postoperatively, although many may experience new penile curvature, reduced penile length, and/or reduced penile sensitivity.
authors.affiliation: Division of Urology, Department of Surgery, The Center for Reconstructive Urology and Men's Health, University of Utah, Salt Lake City, UT. Electronic address: darshan.patel@utah.edu.
authors.forename: Darshan P
authors.initials: DP
authors.lastname: Patel
authors.affiliation: Department of Urology, University of Minnesota, Minneapolis, MN.
authors.forename: Sean P
authors.initials: SP
authors.lastname: Elliott
authors.affiliation: Department of Urology, University of Washington, Seattle, WA.
authors.forename: Bryan B
authors.initials: BB
authors.lastname: Voelzke
authors.affiliation: Department of Urology, University of Iowa Carver College of Medicine, Iowa City, IA.
authors.forename: Bradley A
authors.initials: BA
authors.lastname: Erickson
authors.affiliation: Department of Urology, Ohio State University Wexner Medical Center, Columbus, OH.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: McClung
authors.affiliation: Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT.
authors.forename: Angela P
authors.initials: AP
authors.lastname: Presson
authors.affiliation: Division of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT.
authors.forename: Chong
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Division of Urology, Department of Surgery, The Center for Reconstructive Urology and Men's Health, University of Utah, Salt Lake City, UT.
authors.forename: Jeremy B
authors.initials: JB
authors.lastname: Myers
mesh_terms: D059026:Diagnostic Self Evaluation; D004542:Ejaculation / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation; D010410:Penile Erection / Q000502:physiology*; D010413:Penis; D011446:Prospective Studies; D019529:Sexuality / Q000502:physiology*; D011795:Surveys and Questionnaires; D014521:Urethra / Q000601:surgery*; D014525:Urethral Stricture / Q000601:surgery*; D013521:Urologic Surgical Procedures, Male / Q000379:methods