Fertility in Patients After Surgical Repair of Membranous Urethral Strictures Associated With Pelvic Fractures

Abstract

We evaluated fertility in fourteen patients after surgical repair of membranous urethral strictures associated with pelvic fractures. Eight patients were operated on using Badenoch's method (pull through) and six patients by end-to-end anastomosis of the urethra. All of them have maintained libido and potency after urethroplasty. No ejaculatory disturbance had ever occurred since surgery. Semen analysis was evaluated three months to four years after urethroplasty and serum hormone levels were measured in four patients. The results were as follows: 1) All except 2 patients had normal semen volume (more than 2 ml). 2) Nine patients (64%) had a sperm density of more than 40 x 10(6)/ml. Two patients had a sperm density of 20 to 40 x 10(6)/ml and three patients less than 20 x 10(6)/ml. 3) Nine patients (64%) had a sperm motility of more than 50%, three 30-50% and two less than 30%. 4) Seven patients (50%) had normal semen findings with a sperm density of more than 20 x 10(6)/ml and a sperm motility of more than 50% according to the WHO laboratory manual. 5) Pyospermia (WBC greater than or equal to 10/hpf) was observed in three patients. However, they never had subjective symptoms or objective findings of inflammation. 6) Serum LH, FSH, testosterone and PRL levels were within normal limits. 7) After urethroplasty, two patients married and their wives became pregnant. In conclusion, these results indicate that surgical repair of membranous urethral strictures associated with pelvic fractures has little effect on fertility.

Ejaculatory profiles and fertility in men after posterior urethroplasty for pelvic fracture‐urethral distraction defect injuries

“…Few studies have used formal semen analysis to assess ejaculation and fertility after PFUDD repair, and our study adds to the total provided by Iwamoto et al [6] in 1992. However, the present study has several limitations, the largest being the relatively few men assessed.…”

“…In 1992 Iwamoto et al [6] similarly used semen analyses to evaluate fertility after PFUDD repair in patients in Japan. As in the present study, they found preservation of ejaculation in all 14 men evaluated.…”

Sexual (Dys)function after Urethroplasty

“…There are some specific articles that address fertility in the context of urethroplasty ( Table 8 ) [ 52 , 63 , 65 ]. These studies essentially describe the seminal parameters of patients having undergone posterior urethroplasty.…”

Sexual dysfunction and reproductive disorders as complications of reconstructive urethral surgery.

“…в своем исследовании не нашли разницы в частоте искривления полового члена у пациентов со стриктурами больше или меньше 2,5 см. Группы пациентов были неодонородны, малы (по 11 пациентов в каждой) и включали пациентов с неудачными пластиками и уретротомиями в анамнезе [39]. G. Barbagli также не сообщал о развитии искривления члена, фибротических изменений у пациентов после анастомотической пластики, поскольку показания к операции были ограничены протяженностью стриктуры <3 см [19].…”