Erectile Function After Anterior Urethroplasty

Coursey, John W.; Morey, Allen F.; McAninch, Jack W.; Summerton, Duncan J.; Secrest, Charles L.; White, Paige; Miller, Kennon S.; Pieczonka, Christopher; Hochberg, David A.; Armenakas, Noel A.

doi:10.1016/s0022-5347(05)65549-8

Cited by 123 publications

(81 citation statements)

References 10 publications

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“…These nerves occupy the 1 and 11 o'clock positions at the level of convergence of the crura of the corpora cavernosa. In addition, the corpus spongiosum is highly elastic and can be readily re-anastomosed after mobilization and stricture excision, even in cases of long strictures [8]. Taken together, these findings suggest that anterior urethral reconstruction should not predispose patients to long-term ED.…”

Section: Discussionmentioning

confidence: 88%

Evaluation of erectile function after urethral reconstruction: a prospective study

Xie¹,

Xu²,

Xu³

et al. 2009

Asian J Androl

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We conducted a prospective study of erectile dysfunction (ED) after urethral reconstructive surgery, using the 5-item International Index of Erectile Function (IIEF-5), the Sexual Life Quality Questionnaire (SLQQ) and the Quality of Life Questionnaire (QoLQ). Between January 2003 and July 2007, 125 male patients with urethral strictures underwent urethroplasty, and pre-and post-surgery erectile function was assessed using these three questionnaires. A formula to predict the probability of ED after urethroplasty was derived. At 3 months postoperatively, there was a significant decrease in IIEF-5 (16.57 ± 7.98) and SLQQ scores (28.71 ± 14.84) compared with pre-operative scores (P < 0.05). However, the IIEF-5 scores rebounded at 6 months post-operatively (17.22 ± 8.41). Logistical regression analysis showed that the location of the urethral stricture, the recurrence of strictures and the choice of surgical technique were predictive of the post-operative occurrence of ED. This study identified the clinical risk factors for ED after urethroplasty. Posterior urethral stricture and end-to-end anastomosis were found to have a strong relationship with erectile function. The logistical model derived in this study may be applied to clinical decision algorithms for patients with urethral strictures.

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Section: Discussionmentioning

confidence: 88%

Evaluation of erectile function after urethral reconstruction: a prospective study

Xie¹,

Xu²,

Xu³

et al. 2009

Asian J Androl

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show abstract

“…Incidences in the range of 5-26% have been reported after anastomotic urethroplasty for anterior urethral strictures. 20,21 Interestingly Carlton et al 22 observed that the initial injury, not the reconstructive surgery, is responsible for most of the long-term ED.…”

Section: Discussionmentioning

confidence: 99%

Erectile dysfunction in anterior urethral strictures after urethroplasty with reference to vascular parameters

Mondal

Bandyopadhyay

Mandal

et al. 2016

Medical Journal Armed Forces India

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m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 7 2 ( 2 0 1 6 ) 3 4 4 -3 4and Pharmacological Colour Doppler Ultrasonography (PCDU) for a period of 6 months.Results: Preoperative prevalence of ED assessed by IIEF was found to be 82.8%. Postoperative incidence of ED was 28.5% and new onset ED is 50%. There was no significant change in IIEF values and values of peak systolic velocity and resistive index of cavernosal artery over time. Conclusion:There is significant prevalence of ED with urethral stricture. Despite significant postoperative incidence of ED after urethroplasty, the surgical procedure per se does not result in ED.#

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“…Penile surgery created branches that pierced the tunica albuginea of the CS at 12 o'clock, risking injury during an internal urethrotomy (Mundy, 1993;Coursey et al 2001).…”

Section: Discussionmentioning

confidence: 99%

What is the origin of the arterial vascularization of the corpora cavernosa? A computer‐assisted anatomic dissection study

et al. 2013

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The purpose of this study was to identify the microscopic arterial vascularization of the corpora cavernosa (CC) of the penis using computer-assisted anatomic dissection (CAAD), determine the contribution of the different penile arteries towards this vascularization, detail the nature of cavernospongiosum shunts, and locate the anastomoses between these different arteries. Tissue specimens were taken from five donors who donated their bodies to science. The specimens were fixed in 10% formalin and sliced into a series of five 5-lm sections at intervals of 200 lm. The first section was stained with hematoxylin-eosin or Masson's trichrome and the second with anti-protein S100. The cavernous artery of the penis is not the only source of arterial vascularization of the CC. In four of the five cases studied, we found two to four perforating branches arising from the dorsal arteries of the penis that join up with the cavernous artery of the penis or that are solely responsible for the vascularization of the distal third of the penis. The bulbo-urethral and urethral arteries are situated outside of the tunica albuginea of the corpus spongiosum on their lateral and dorsal sides. The anastomoses do not occur between the cavernous artery of the penis and the corpus spongiosum but between the cavernous artery of the penis and the urethral artery on the surface of the tunica albuginea. All of these arteries are accompanied by nerve branches. The CC were found to be vascularized by both cavernous and dorsal arteries of the penis. Intrapenile vascularization is organized around four arterial axes, which are anastomosed by multiple neurovascular shunts.

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Erectile Function After Anterior Urethroplasty

Abstract: Overall anterior urethral reconstruction appears no more likely to cause long-term postoperative sexual dysfunction than circumcision. Men with a long stricture may be at increased risk for transient erectile changes.

Cited by 123 publications

References 10 publications

Evaluation of erectile function after urethral reconstruction: a prospective study

Evaluation of erectile function after urethral reconstruction: a prospective study

Erectile dysfunction in anterior urethral strictures after urethroplasty with reference to vascular parameters

What is the origin of the arterial vascularization of the corpora cavernosa? A computer‐assisted anatomic dissection study

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