Erectile function after anterior urethroplasty

Purpose: We ascertained the impact of anterior urethroplasty on male sexual function. Materials and Methods: A validated questionnaire was mailed to 200 men who underwent anterior urethroplasty to evaluate postoperative sexual function. Questions addressed the change in erect penile length and angle, patient s atisfaction with erection, preoperative and postoperative coital frequency, and change in erection noted by the sexual partner. Results were stratifie d by the urethral reconstruction method, namely anastomosis, buccal mucosal graft, penile flap and all others, and compared with those in a similar gr oup of men who underwent circumcision only. Results: Of the 200 men who underwent urethroplasty 152 who were 17 to 83 y ears old (mean age 45.7) completed the questionnaire. Average followup was 36 months (range 3 to 149). Overall there was a similar incidence of sexual problems after urethroplasty and circumcision. Penile skin flap urethropla sty was associated with a slightly higher incidence of impaired sexual func tion than other procedures (p >0.05). Men with a longer stricture were most likely to report major changes in erectile function and penile length (p < 0.05) but improvement was evident with time in 61.8%. Conclusions: Overall anterior urethral reconstruction appears no more likel y to cause longterm postoperative sexual dysfunction than circumcision. Men with a long stricture may be at increased risk for transient erectile chan ges.