PD31-11 PATIENT, STRICTURE, AND URETHROPLASTY PREDICTORS OF ERECTILE DYSFUNCTION AFTER URETHROPLASTY FOR BULBAR URETHRAL STRICTURES

Abstract

You have accessJournal of UrologyCME1 May 2022PD31-11 PATIENT, STRICTURE, AND URETHROPLASTY PREDICTORS OF ERECTILE DYSFUNCTION AFTER URETHROPLASTY FOR BULBAR URETHRAL STRICTURES Justin Drobish, Shawn Grove, Nejd Alsikafi, Joshua Broghammer, Jill Buckley, Sean Elliott, Jeremy Myers, Andrew Peterson, Keith Rourke, Thomas Smith, Alex Vanni, Lee Zhao, and Bradley Erickson Justin DrobishJustin Drobish More articles by this author , Shawn GroveShawn Grove More articles by this author , Nejd AlsikafiNejd Alsikafi More articles by this author , Joshua BroghammerJoshua Broghammer More articles by this author , Jill BuckleyJill Buckley More articles by this author , Sean ElliottSean Elliott More articles by this author , Jeremy MyersJeremy Myers More articles by this author , Andrew PetersonAndrew Peterson More articles by this author , Keith RourkeKeith Rourke More articles by this author , Thomas SmithThomas Smith More articles by this author , Alex VanniAlex Vanni More articles by this author , Lee ZhaoLee Zhao More articles by this author , and Bradley EricksonBradley Erickson More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002582.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Bulbar urethroplasty (BU) for urethral stricture disease can significantly improve urinary quality of life (QOL). However, prior studies have shown that while erectile dysfunction (ED) is rare, its presence after BU negatively affects QOL and satisfaction regardless of stricture outcome. Herein we analyze patient, stricture and urethroplasty variables and their association with post-BU ED. METHODS: The Trauma and Urologic Reconstruction Network of Surgeons (TURNS) prospective database was used to create a cohort of bulbar (S1a/S1b; no posterior or penile urethral extension) urethral strictures that underwent single-stage BU from 2010 to 2018 with minimum 3-year clinical follow-up (database + retrospective chart review) not associated with hypospadias. Patient, stricture, and repair variables were analyzed for their association with ED, which was determined with retrospective chart review of both urologic and non-urologic clinical visits in the 12 months after BU, looking for patient complaints of ED and/or new prescriptions for ED medications, with uni- and multivariable models. Patient-reported recovery of erectile function was also assessed with chart review. RESULTS: At a median follow-up time was 65.1 months, 108 (7.3%) of 1480 study subjects were noted to have clinically significant post-BU ED. Uni- and multivariate predictors of post-BU ED are shown in the Table. On multivariate analysis, a history of pelvic radiation and BU involving urethral excision/transection significantly increased the odds of ED. Recovery of function was confirmed 56 (51.9%) at a median follow-up of 19 mo. and was not affected by repair type. CONCLUSIONS: Clinically significant changes in erectile function occurs in at least 7% of BU cases, with urethral excision/transection and radiation history significantly increasing the odds. Notably, traditional patient factors associated with ED, including as age, BMI and smoking history, did not affect the development of de novo post-BU ED. Most, but not all, patients appear to recover with time. Source of Funding: NIDDK 1R21DK115945-01 © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e545 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Justin Drobish More articles by this author Shawn Grove More articles by this author Nejd Alsikafi More articles by this author Joshua Broghammer More articles by this author Jill Buckley More articles by this author Sean Elliott More articles by this author Jeremy Myers More articles by this author Andrew Peterson More articles by this author Keith Rourke More articles by this author Thomas Smith More articles by this author Alex Vanni More articles by this author Lee Zhao More articles by this author Bradley Erickson More articles by this author Expand All Advertisement PDF DownloadLoading ...