Prospective Analysis of Erectile Dysfunction After Anterior Urethroplasty: Incidence and Recovery of Function
Prospective Analysis of Erectile Dysfunction After Anterior Urethroplasty: Incidence and Recovery of Function
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DOI：
10.1016/j.juro.2009.10.017
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发表时间：
2010-02-01
影响因子：
6.6
通讯作者：
Gonzalez, Christopher M.
中科院分区：
文献类型：
--
作者：
Erickson, Bradley A.;Granieri, Michael A.;Gonzalez, Christopher M.
目的：前尿道成形术已被证明对勃起功能有负面影响。功能恢复是常见的，但恢复的可能性和程度尚未完全阐明。材料和方法：2006年10月至2008年5月，在一项前瞻性研究中，研究了男性前尿道成形术对勃起功能的影响。国际勃起功能指数在术前和术后的所有随访中完成。比较手术前后勃起功能的差异。结果：52例前尿道成形术患者纳入研究。修复部位：球(35例)、阴茎(17例)。球部尿路成形术中，20例行切除一期吻合术，15例行吻合口扩大修补术。所有阴茎修补术均为腹侧嵌体修补术(11例)或2期嵌体修补术(6例)。术后勃起功能障碍20例(38%)，其中18例完全恢复，术后平均190天(92~398天)。在术前勃起功能正常的患者中，球部成形术比阴茎成形术更容易导致勃起功能障碍(76%比38%，p=0.05)。球内尿道切除和一期吻合术导致勃起功能障碍的发生率略高于吻合术(50%比26%，p=0.16)。结论：前尿道成形术引起勃起功能障碍的患者约占40%，但大多数患者在6个月后恢复。球部尿路成形术对勃起功能的影响似乎比阴茎尿路成形术更大，这可能是由于球部尿路接近负责勃起的神经所致。
Purpose: Anterior urethroplasty has been shown to negatively impact erectile function. Recovery of function is common but the likelihood and extent of recovery have not been fully elucidated.Materials and Methods: Between October 2006 and May 2008 men undergoing anterior urethroplasty were enrolled in a prospective study to evaluate the effects of urethroplasty on erectile function. The International Index of Erectile Function was completed preoperatively and on all subsequent postoperative visits. Preoperative and postoperative erectile function was compared.Results: A total of 52 patients who underwent anterior urethroplasty were included in the study. Repair locations were bulbar (35) and penile (17). Of the patients undergoing bulbar urethroplasty 20 had excision and primary anastomosis, and 15 had augmented anastomotic repair. All penile repairs were ventral onlay repair (11) or inlay repair in 2 stages (6). Postoperative erectile dysfunction was noted in 20 (38%) men, of whom 18 recovered fully at a mean postoperative period of 190 days (range 92 to 398). In patients with normal preoperative erectile function bulbar urethroplasty was more likely than penile urethroplasty to cause erectile dysfunction (76% vs 38%, p = 0.05). Within the bulbar urethra excision and primary anastomosis repairs led to-slightly higher erectile dysfunction rates than augmented anastomotic repairs (50% vs 26%, p = 0.16).Conclusions: Anterior urethroplasty caused erectile dysfunction in approximately 40% of patients, although recovery was seen in most by 6 months. Bulbar urethroplasty appears to affect erectile function to a greater extent than penile urethroplasty, which may be explained by the proximity of the bulbar urethra to the nerves responsible for erection.