title: Effect of endourological procedures on erectile function: a prospective cohort study.
abstract: BACKGROUND
  Many patients offered endourological procedures are concerned about potential sexual dysfunction following endoscopy, and there are scarce published data to support an evidence-based response. We aim to assess possible effects of endourological procedures on sexual activity and erectile function.
  
  
  METHODS
  Sexually active men undergoing cystoscopy and/or upper tract endourological procedures were enrolled and evaluated using the IIEF-5 score and the IPSS, filled the day before and 10 days and 45-60 days after the procedure. Patients' characteristics (age, chronic medical condition, smoking, and medications) were recorded. The primary outcome was the change in the IIEF-5 score.
  
  
  RESULTS
  One hundred patients aged 24-60 years (mean 37.4) underwent endourological procedures (42 PCNLs, 30 ureteroscopies, 22 retrograde ureteropyelographies ± stenting, and 6 cystolitholapaxies) between January and August 2014. Preoperative IPSS ranged from 0 to 32 (mean [SD] 11.93 [8.64]), while IIEF-5 ranged from 14 to 25 (mean [SD] 21.63 [2.96]), with eight patients in the mild to moderate (12-16) ED range, 31 mild ED (17-21), and 59 no ED (22-25). Following the procedure, the IPSS improved (mean IPSS down from 11.9 to 6.1 at 10 days and 6.2 at 45 days, P < 0.001), while the IIEF remained unchanged [21.6 preoperative to 21.0 at 10 days (P = 0.43) and 21.7 at 45 days (P = 0.81)]. Patients with indwelling ureteric stents (28 patients) had significant LUTS postoperatively with a mean [SD] IPSS of 9.8 [7.2] at 10 days and 11.6 [7.8] at 45 days. The IIEF-5 score was not affected with a mean [SD] of 21.5 [3.3] at 10 days and 21.8 [3.1] at 45 days, compared to 22.0 [3.0] preoperatively (P = 0.44).
  
  
  CONCLUSIONS
  Endoscopic procedures did not negatively impact erectile function and sexual activity.
authors.affiliation: Cairo University, No. 8 Ahmed Ibn Hanbal St., 7th District, Nasr City, Cairo, Egypt.
authors.forename: Ashraf
authors.initials: A
authors.lastname: Mosharafa
authors.affiliation: Cairo University, No. 8 Ahmed Ibn Hanbal St., 7th District, Nasr City, Cairo, Egypt. Mahmoud.abdelhamid@kasralainy.edu.eg.
authors.forename: Mahmoud Abd El
authors.initials: MA
authors.lastname: Hamid
authors.affiliation: Cairo University, No. 8 Ahmed Ibn Hanbal St., 7th District, Nasr City, Cairo, Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Tawfik
authors.affiliation: Cairo University, No. 8 Ahmed Ibn Hanbal St., 7th District, Nasr City, Cairo, Egypt.
authors.forename: Omar Abd El
authors.initials: OA
authors.lastname: Rzzak
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003558:Cystoscopy / Q000009:adverse effects* / Q000379:methods; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods*; D007172:Erectile Dysfunction / Q000209:etiology* / Q000503:physiopathology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D061214:Patient Safety; D011446:Prospective Studies; D020127:Recovery of Function; D018570:Risk Assessment; D012725:Sexual Behavior; D062606:Tertiary Care Centers; D013520:Urologic Surgical Procedures / Q000009:adverse effects* / Q000379:methods; D055815:Young Adult
keywords: Endourology; Erectile function; IIEF; Stents