Department of Urology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.
Study Type - Therapy (case series) Level of Evidence 4.
What's known on the subject? and What does the study add? Our knowledge of surgical casualty in the context of sexual function is limited to few oncological operations. We assessed whether transurethral endoscopic surgery may impair sexual function and we found that these operations cause temporary postoperative sexual dysfunction, which recovers within 3 months. These findings are important in preoperative patient counseling.
To investigate whether endourological interventions are associated with postoperative sexual dysfunction.
The study comprises a consecutive and prospective series of patients, referred for endourological procedures. General anaesthesia was used and JJ stents were placed when required. Changes in sexual function, as assessed by the International Index of Erectile Function questionnaire that the participants filled in the day before the procedure and 1 month and up to 3 months afterwards, were analysed.
The study group consisted of 50 men aged (mean ±sd) 45 ± 13 years, of whom 25 underwent ureteroscopy, 9 underwent retrograde intrarenal surgery (RIRS) and 16 underwent combined RIRS and percutaneous nephrolithotomy. JJ stents were postoperatively placed in 33 patients (66%). The study cohort self-reported a significant decrease in erectile function (P= 0.007), intercourse satisfaction (P < 0.001), orgasmic function (P= 0.001), sexual desire (P < 0.001) and overall satisfaction (P= 0.002) at 1 month following endourological procedures. This dysfunction was not related to chronic disease, age, smoking, preoperative or postoperative stenting, type of procedure, operative duration or surgeon expertise. The sexual function of all subjects returned to baseline within 3 months (P < 0.005). Postoperative erectile function in the stented group revealed a negative tendency that did not reach statistical significance.
Endourological procedures are associated with temporary postoperative sexual dysfunction, which completely recovers within 3 months. The impact of postoperative stenting on sexual function was not significant. These findings contribute to enhanced preoperative patient counselling.
Sofer M, Yehiely R, Greenstein A, Bar-Yosef Y, Matzkin H, Chen J. Are you the author?
Reference: BJU Int. 2011 Apr 20. Epub ahead of print.