الفهرس 
Introduction
Surgical anatomy of the Urethra and PenisOnly 14 pages are availabe for public view
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Abstract
One of the more concerning complications of urethroplasty is postoperative ED. The theoretical risk of ED comes from the close relationship of the cavernous nerves with the proximal urethra when they emerge from the pelvic floor and this risk is supported by reports of ED after urethroplasty. Fortunately most studies have shown an improvement over time, although to our knowledge long-term, prospective studies specifically evaluating the effect of anterior urethroplasty on EF do not exist.
In this study, we evaluated the effect of anterior urethroplasty on male sexual function.
This study is a prospective hospital-based study that had been carried out at Assiut Urology and Nephrology Hospital in the period from March 2015 to march 2016. The study included 35 patients who underwent anterior urethroplasty. The data were collected before surgery and at follow up of 3 months after completing the treatment and another evaluation was done at 6 months.
The whole patients participated in the study were with bulbar urethral stricture. The length of the urethral stricture pre-operative was 1.5-5 cm with the mean length=2.8±1.3 cm. The etiology of the urethral stricture was post-inflammatory in 14 patients (40%) and post-traumatic in 21 patients (60%). The type of urethroplasty in the studied patients was anastomotic urethroplasty in 23 patients (65.7%) and free graft urethroplasty in 12 patients (34.3%).
According to the impact of urethroplasty on erectile function. After urethroplasty, 9 patients (25.7%) developed ED. Three months post urethroplasty, with statistically significant difference (p-value=0.001). While 6 months post urethroplasty, 2 patients (5.7%) showed ED while 33 patients showed normal erectile function, with no statistically significant difference (p-value=0.15).
As regard the impact of urethroplasty on IIEF score, the pre-operative IIEF score for the studied 35 patients was 22-25 (mean=23±0.8). Three months post urethroplasty, there was significant decrease in the IIEF score compared to the pre-operative scores that was declined to 14-23 (mean=20.3±3) with statistically significant difference (p-value<0.001). Six months post urethroplasty, the IIEF score was rebounded to 18-25 (mean=23.0±1.5) with no statistically significant difference (p-value=0.085).
As regard the impact of type of urethroplasty and incidence of ED, Our study showed that the incidence of ED was higher in patients underwent anastomotic repair than in patients underwent free graft urethroplasty. There were 23 patients underwent anastomotic urethroplasty, nine of them developed ED post-operative (39.1%). Although 12 patients underwent free graft urethroplasty, none of them developed post-operative ED (0%). With a statistically significant difference between the 2 groups (p-value=0.012).
According to the impact of the urethral stricture length on erectile function post urethroplasty, our study detected that the impact on erectile function after urethroplasty is greater in shorter urethral stricture segments (mean length 1.9±0.2 cm) than in longer urethral stricture segments (mean length 3.1±1.3 cm) with statistically significant difference between the 2 groups (p-value=0.001).
In our study, the ejaculatory function and orgasm were evaluated by Ejaculation/ orgasm score (EO score). Our study reported that the ejaculation/orgasm score (EO score) for the studied 35 patients pre-operative was 8-10 (mean=8.9±0.7). Three months post urethroplasty, the EO score was declined to 6-10 (mean=8.1±1.2) with statistically significant difference (p-value<0.002).While 6 months post urethroplasty, the EO score was rebounded to 8-10 (mean=8.8±0.6) with no statistically significant difference (p-value<0.86).