BACKGROUND: Urethral stricture is one of the most common diseases of the male genitourinary system, leading to urinary dysfunction and a significant reduction in patientsʼ quality of life. The most effective treatment for urethral stricture is urethroplasty, which restores urethral patency and achieves lasting clinical results.

Although this surgical procedure is highly effective, an important aspect of this surgical treatment is the patientʼs sexual function, specifically erectile function. Damage to the vascular and nerve bundles, the characteristics of the urethral structure, and the choice of surgical technique can potentially impact erectile function in the postoperative period. According to literature, the incidence of complications after urethroplasty depends on the severity of the disease and the surgical method. For this reason, it is important to study the risk factors for erectile dysfunction after urethroplasty. AIM: To assess erectile function in men pre- and post-urethroplasty and to identify causes of its impairment in the postoperative period.

METHODS: The study included 200 patients with urethral stricture who underwent urethroplasty. 100 of them formed group 1 – men with sexual dysfunction, and the remaining 100 (group 2) – men without sexual dysfunction. When assessing erectile function, the presence of risk factors for erectile dysfunction in patients and the surgical technique (with and without transection of the corpus spongiosum) were taken into account. Erectile function was assessed using the International Index of Erectile Function questionnaire. The assessment was conducted before surgery and 12 months after surgical treatment. Statistical data processing was performed using the licensed software package Statistica 14. The statistical significance of indicators between groups was assessed using Studentʼs t-test. The conformity of experimental data to a normal distribution was checked using the Kolmogorov–Smirnov test. The obtained data are presented as M ± σ, where M is the arithmetic mean, and σ is the standard deviation of the sample. The degree of interrelationship of the obtained data was assessed by calculating Spearmanʼs correlation coefficient. Differences were considered statistically significant at p <0.05.

RESULTS: Patients from the study groups did not differ in age, anthropometric, and medico-social characteristics. In patients from group 1 (group of patients with erectile dysfunction), the following parameters were significantly more common compared to group 2: urethral stricture length ≥3 cm, history of urethral stricture treatment, and transection of the corpus spongiosum during surgery (p <0.05). The International Index of Erectile Function scores before surgery did not differ statistically significantly between the study groups (p >0.05). Twelve months after surgical treatment, significant improvement in erectile function was observed in both groups; however, the scores in group 2 were higher (p >0.05). The study found a correlation between erectile dysfunction and urethral stricture length ≥3 cm (r = 0.72), history of urethral stricture treatment (r = 0.63), and transection of the corpus spongiosum during surgery (r = 0.56).

CONCLUSION: Surgical treatment (urethroplasty) is associated with improvement in erectile function in the long-term postoperative period. The risk of erectile dysfunction is significantly increased in patients with a history of urethral stricture treatment, as well as with extensive urethral strictures and transection of the corpus spongiosum during surgery. Analysis and consideration of these risk factors are important for predicting further sexual function and selecting the optimal surgical approach.