Sexual Dysfunction in Urethral Reconstruction: A Review of the Literature

Abstract

Introduction: Urethral stricture disease accounts for 5,000 hospitalizations and 1.5 million office visits per year. Urethral reconstruction has become more commonplace with the recognition of the poor long-term success of the endoscopic management of stricture disease. Sexual dysfunction related to the surgical management of urethral strictures is an under-recognized sequela.

Aim: To characterize and elucidate the various factors that contribute to sexual dysfunction after urethroplasty and hypospadias reconstruction to improve surgical decision making and patient counseling.

Methods: A Medline PubMed search was used to identify articles of interest related to sexual dysfunction and urethral stricture disease. The following were included in the search for articles of interest: "urethroplasty and sexual dysfunction," "urethral stricture and erectile dysfunction," "urethroplasty and ejaculatory dysfunction," and "sexual function and hypospadias."

Main outcome measure: Rates and types of sexual dysfunction after urethral reconstructive surgery.

Results: Urethral reconstructive surgery has the potential to affect many domains of sexual function and thus negatively affect quality of life for patients with urethral stricture disease and hypospadias. These domains include erectile function, ejaculatory function, penile shortening, penile curvature, and altered penile sensation. The etiology, location, length and type of urethral stricture, and importantly the reconstructive technique have different repercussions on sexual function.

Conclusion: Sexual dysfunction after urethral reconstruction is underappreciated and has a significant consequence on quality of life. Thus, it is important to recognize these sequelae and counsel patients accordingly. Benson CR, Hoang L, Clavell-Hernández J, Wang R. Sexual Dysfunction in Urethral Reconstruction: A Review of the Literature. Sex Med Rev 2018;6:492-503.

Keywords: Erectile Dysfunction; Hypospadias; Physiologic; Reconstructive Surgical Procedures; Sexual Dysfunction; Urethral Stricture.