Abstract
Abstract
Objective
To assess changes in sexual function six months after urethroplasty using the 15-item International Index of Erectile Function (IIEF-15) and to examine associations with age, stricture length, and surgical technique.
Materials and Methods
Patients undergoing urethroplasty between August 2024 and August 2025 were assessed preoperatively and six months postoperatively. Patients were stratified by age (< 60 vs. ≥60 years), urethroplasty technique (anastomotic vs. augmentation), and stricture length (< 2 vs. ≥2 cm). Changes in IIEF domains were evaluated, and multivariable linear regression was performed.
Results
Among 56 patients with complete paired assessments, the mean age was 52.79 years, and the median stricture length was 2.00 cm. At six months, erectile function decreased from 24.25 to 18.68 (p < 0.001), intercourse satisfaction from 12.30 to 9.13 (p < 0.001), and sexual desire from 8.00 to 7.52 (p = 0.013). After adjustment, age ≥ 60 years was associated with a greater decline in erectile function (coefficient = -6.10; p < 0.001). Augmentation urethroplasty was associated with a more favorable change in intercourse satisfaction than anastomotic urethroplasty (coefficient = 4.04; p < 0.001). Stricture length was not independently associated with changes in any IIEF domain.
Conclusion
Urethroplasty was associated with domain-specific changes in sexual function at six months. Older age was associated with a greater decline in erectile function, whereas augmentation urethroplasty was associated with more favorable intercourse-satisfaction outcomes. Larger multicenter studies with longer follow-up are warranted.