Erectile dysfunction post-perineal anastomotic urethroplasty for traumatic urethral injuries: analysis of incidence and possibility of recovery.

PURPOSE: To evaluate the incidence of erectile dysfunction (ED) and recoverability of erectile function (EF) after anastomotic urethroplasty for traumatic urethral injuries (TUIs) of different etiologies.

METHODS

A retrospective review for patients' records underwent perineal anastomotic urethroplasty for TUIs from June 1998 to January 2014 was conducted. Those patients were contacted and evaluated using the International Index of erectile function questionnaire in sexually active men, and in unmarried men, the single-question self-report of ED was used. Patients with ED underwent penile color Doppler ultrasonography.

RESULTS

Overall, 81 patients were included in the study. The incidences of ED following urethroplasty for TUIs were 72.3, 35.3 and 0% in cases due to pelvic fracture, straddle and iatrogenic injuries, respectively. None of the patients reported deterioration of EF after urethroplasty. Seven (13.5%) patients reported recovery of their EF within 2 years after trauma. The probability of recovery of EF after PFUI was 9% compared to 28.6 and 100% in patients with straddle and iatrogenic urethral injuries, respectively. Patients with type C pelvic fracture had no chance for EF recoverability.

CONCLUSIONS

PFUIs have a probability of causing ED as much as 72% compared to 35 and 0% in men with straddle and iatrogenic urethral injuries, respectively. Anastomotic urethroplasty has no deleterious effect on EF. A tendency for higher recoverability of EF could be observed after iatrogenic urethral injuries followed by straddle injury then PFUIs. The probability of recovery decreased proportionally with severity of pelvic trauma.