Impact of Visual Internal Urethrotomy on Sexual Function in Patients with Urethral Stricture

Abstract

Visual internal urethrotomy (VIU) is an option for the management of urethral stricture. However, little is known regarding sexual function after surgery. Seventy-six patients who underwent VIU were evaluated by using the Korean version of the Male Sexual Health Questionnaire. Three sexual functional domains of erection (EFD), satisfaction (SAD), and ejaculation (EjFD) were assessed at baseline, 3 months, 6 months, and 12 months after surgery. We assessed clinical factors (age, etiology, and maximum flow rate) and radiologic factors (stricture site, stricture length, frequency of recurrence, and duration until first recurrence). We compared with each sexual functional domain score by age group (range: 40-49, 50-59, 60-69, and 70-79 years). A total of 76 men with mean age of 57.1±13.07 years completed this study. In univariate analysis, there were significant losses of EFD scores at postoperative 3 months for all age groups (P<0.05). And these scores were regained after postoperative 6 months. There was no statistically significant difference in SAD. Age, length of stricture, frequency of recurrence, and duration until first recurrence were significant differences in EjFD (P<0.001, P=0.006, P=0.005, and P=0.013, respectively). In 40 to 49 and 50 to 59 age groups, VIU improves EjFD (P<0.001, respectively). Multiple linear regression analysis revealed that age and stricture length were independent factors of VIU on EjFD (P<0.001 and P=0.013, respectively). VIU can improve ejaculatory function in younger age group (40-59 years). Age and stricture length are independent predictive factors of VIU on ejaculatory function.