Objective To evaluate sexual function after staged penile urethroplasty with oral mucosal graft (OMG). Methods We identified men with completed staged penile urethroplasty with OMG from the Trauma and Urologic Reconstruction Network of Surgeons database between January 1, 2010 and May 1, 2014. Our primary outcome was change in total Sexual Health Inventory for Men (SHIM) and total Male Sexual Health Questionnaire Ejaculatory Domain (MSHQ-EjD) Short Form at baseline vs after the second stage of the procedure. Second, we assessed subjective changes in penile curvature, length, and sensation. Results Thirty-three patients were included with a mean age of 45 years and mean body mass index of 27.6 kg/m2. Urethral strictures arose from failed hypospadias repair in 52% and lichen sclerosus in 27%. Fifty-two percent of patients reported a previous urethroplasty. The median follow-up time between the second stage procedure and postoperative questionnaires was 6.3 months (interquartile range: 3.5-13.3). There was no significant change in the total SHIM (Δ0.64, 95% confidence interval [CI]: -3.00∼1.72) and MSHQ-EjD (Δ1.55, 95% CI: -1.53∼4.63) scores preoperatively vs postoperatively. In addition, 32% reported improved and 52% no change in satisfaction with sexual intercourse (SHIM Q5). Forty percent of patients reported reduced and 45% no change in bother with ejaculation after surgery (MSHQ-EjD Q4). Men reported new penile curvature (23%), loss of penile length (55%), and altered penile sensitivity (45%) after surgery. Conclusion Patients undergoing staged penile urethroplasty with OMG are likely to have minimal changes in erectile and ejaculatory function postoperatively, although many may experience new penile curvature, reduced penile length, and/or reduced penile sensitivity.
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Financial Disclosure: All conflicts of interest, including specific financial interests and relationships and affiliations relevant to the subject matter and materials discussed in this manuscript (employment/affiliation, grants or funding, honoraria, stock ownership or options, expert testimony, royalties, or patents filed, received, or pending), are the following: DPP was supported in part by a generous reconstructive urology educational grant from American Medical Systems, Inc., Minnetonka, MN. American Medical Systems, Inc. had no role in study concept, design, data acquisition and analysis, or manuscript drafting and revision. The remaining authors declare that they have no relevant financial interests.
Funding Support: This investigation was supported by the University of Utah Study Design and Biostatistics Center, with funding in part from the National Center for Research Resources and the National Center for Advancing Translational Sciences , National Institutes of Health , through Grant 8UL1TR000105 (formerly UL1RR025764 ). Funded under National Center for Research Resources and National Institutes of Health through Grant KL2RR025015 .
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