MP81-07 PATIENT-REPORTED ASSESSMENT OF ANATOMICAL, NEUROLOGICAL AND FUNCTIONAL CHANGES OF THE GENITALIA AFTER ANTERIOR URETHROPLASTY: INCIDENCE AND RECOVERY OF FUNCTION

Abstract

You have accessJournal of UrologySexual Function/Dysfunction: Penis/Testis/Urethra: Benign Disease & Malignant Disease II1 Apr 2016MP81-07 PATIENT-REPORTED ASSESSMENT OF ANATOMICAL, NEUROLOGICAL AND FUNCTIONAL CHANGES OF THE GENITALIA AFTER ANTERIOR URETHROPLASTY: INCIDENCE AND RECOVERY OF FUNCTION Christopher Tam, Maria Voznesensky, Benjamin Breyer, Sean Elliott, Christopher McClung, Jeremy Myers, Alex Vanni, Bryan Voelzke, and Bradley Erickson Christopher TamChristopher Tam More articles by this author , Maria VoznesenskyMaria Voznesensky More articles by this author , Benjamin BreyerBenjamin Breyer More articles by this author , Sean ElliottSean Elliott More articles by this author , Christopher McClungChristopher McClung More articles by this author , Jeremy MyersJeremy Myers More articles by this author , Alex VanniAlex Vanni More articles by this author , Bryan VoelzkeBryan Voelzke More articles by this author , and Bradley EricksonBradley Erickson More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2060AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Anterior urethroplasty is thought to cause erectile dysfunction in only a small percentage of patients, but little is known about how the patient perceives other changes to their genitalia after surgery. The purpose of this study was to evaluate patient-reported post-operative anatomical, neurological and functional changes after urethroplasty. We hypothesized higher rates of dysfunction and slower recovery in patients with longer strictures and those undergoing penile urethroplasty. METHODS We retrospectively reviewed a multi-institutional urethroplasty database for patients that completed a post-operative sexual function questionnaire assessing patient-reported penile anatomical changes. The questionnaire was given routinely at 3 months and then again at all subsequent post-operative visits. Predictors of initial sexual dysfunction were analyzed using logistic regression; recovery of function was assessed with Kaplan-Meier estimations. RESULTS A total of 392 men completed at least two post-operative questionnaires. Rates of initial (3 mo) sexual dysfunction were high with 31% of subjects reporting alteration of sexual intercourse (relative to pre-op), 20% reporting de novo penile curvature, 37% noticing loss of penile length, and 22% experiencing decreased penile sensitivity. Partner-reported erectile dysfunction was similar to patient reported rates at 32%. Patients undergoing penile urethroplasty were significantly more likely to report penile curvature (OR 3.65, 95% CI 1.67-7.97) and penile sensation loss (OR 2.86, 1.27-6.44) versus bulbar repair at early follow-up. Stricture length or repair type (excisional versus buccal) did not independently predict post-operative sexual dysfunction. Recovery of function was predicted for most patients by 3 years (Figure 1), though significantly slower rates of recovery of penile length (HR 1.38), penile curvature (HR 1.41) and penile sensation (HR 1.42) were seen in penile repairs as compared to bulbar repairs. CONCLUSIONS Patient-reported rates of genital sensory and anatomical alteration after anterior urethroplasty are high. Recovery is common but can take many years, with higher rates of dysfunction and slower recovery in men undergoing penile urethroplasty. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1055 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Christopher Tam More articles by this author Maria Voznesensky More articles by this author Benjamin Breyer More articles by this author Sean Elliott More articles by this author Christopher McClung More articles by this author Jeremy Myers More articles by this author Alex Vanni More articles by this author Bryan Voelzke More articles by this author Bradley Erickson More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...