MP60-07 DO POST-VOID DRIBBLING AND EJACULATORY DYSFUNCTION AFTER URETHROPLASTY SHARE THE SAME ETIOLOGY?

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Urethral Reconstruction (including Stricture, Diverticulum) II (MP60)1 Apr 2020MP60-07 DO POST-VOID DRIBBLING AND EJACULATORY DYSFUNCTION AFTER URETHROPLASTY SHARE THE SAME ETIOLOGY? Ayman Soubra*, Shawn Grove, Joseph Pariser, Bryan Voelzke, Jeremy Myers, Bradley Erickson, Nejd Alsikafi, Benjamin Breyer, Alex Vanni, Jill Buckley, Joshua Broghammer, Keith Rourke, and Sean Elliott Ayman Soubra*Ayman Soubra* More articles by this author , Shawn GroveShawn Grove More articles by this author , Joseph PariserJoseph Pariser More articles by this author , Bryan VoelzkeBryan Voelzke More articles by this author , Jeremy MyersJeremy Myers More articles by this author , Bradley EricksonBradley Erickson More articles by this author , Nejd AlsikafiNejd Alsikafi More articles by this author , Benjamin BreyerBenjamin Breyer More articles by this author , Alex VanniAlex Vanni More articles by this author , Jill BuckleyJill Buckley More articles by this author , Joshua BroghammerJoshua Broghammer More articles by this author , Keith RourkeKeith Rourke More articles by this author , and Sean ElliottSean Elliott More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000929.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Post-void dribbling (PVD) and ejaculatory dysfunction (EjD) are common after urethroplasty (UP). Although the etiology remains unknown, they are thought to share a similar etiology because they are both due to a failure to express small volumes of urethral fluid. Theories include damage to the bulbospongiosus muscle (BS) or adjacent nerves, graft sacculation and loss of urethral elasticity. We sought to determine whether post-UP PVD and EjD are associated with each other and whether that association varies with BS damage or graft placement. METHODS: From the TURNS database, we included men who underwent anterior UP with ≥1 follow-up visit, 2-12 months after surgery, with completed questionnaires. We excluded men with prior UP or hypospadias repair. From the Male Sexual Health Questionnaire we used question 2 (“How would you rate the strength or force of your ejaculation”). From the Jackson et al urethral stricture patient reported outcome measure we used question 6 (“How often have you had a slight wetting of your pants a few minutes after you had finished urinating and had dressed yourself?”). The association between the frequency distribution of scores on these questions was compared using Chi square. Subset analysis compared the frequency distribution in bulbar UP (as a surrogate for BS damage), penile UP, and bulbar UP with graft vs. excision and primary anastomosis (EPA). RESULTS: Among 772 men who met the inclusion criteria, PVD and EjD were associated (p< 0.01; Figure). The association persisted in all of the following subsets: bulbar UP (p< 0.01), penile UP (p= 0.03), bulbar onlay graft UP (p= 0.03), penile onlay graft UP (p= 0.3) and bulbar EPA (p< 0.01). There were too few ventral graft procedures to compare dorsal vs. ventral onlay. CONCLUSIONS: Post-UP PVD and EjD are associated, supporting the theory of a common etiology. The association persists whether the UP is in the penile or bulbar urethra, suggesting that BS damage is not the primary cause. The association persists whether the bulbar UP is done with a graft vs EPA, suggesting that graft placement is not the cause; but we were unable to compare dorsal vs. ventral graft. By exclusion, these symptoms may be due to a loss of elasticity that is inherent to any UP (with or without a graft) or due to a neurologic cause. Source of Funding: none © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e891-e892 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Ayman Soubra* More articles by this author Shawn Grove More articles by this author Joseph Pariser More articles by this author Bryan Voelzke More articles by this author Jeremy Myers More articles by this author Bradley Erickson More articles by this author Nejd Alsikafi More articles by this author Benjamin Breyer More articles by this author Alex Vanni More articles by this author Jill Buckley More articles by this author Joshua Broghammer More articles by this author Keith Rourke More articles by this author Sean Elliott More articles by this author Expand All Advertisement PDF downloadLoading ...