Sexual dysfunction and reproductive disorders as complications of reconstructive urethral surgery.
Authors:   the Department of Obstetrics, Gynecology, Perinatology, and Reproductive Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University of the Ministry of Health of the Russian Federation, R.U. Mammaev ,   Moscow, Russia, S.I. Gamidov ,   the Department of Obstetrics, Gynecology, Perinatology, and Reproductive Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University of the Ministry of Health of the Russian Federation, Head of the Department of Andrology and Urology, Federal State Budgetary Scientific Institution National Medical Research Center for Obstetrics, Gynecology, and Perinatology named after V.I. Kulakov of the Ministry of Health of the Russian Federation; Moscow, Russia, T.V. Shatylko ,   the Department of Andrology and Urology, FSBSI National Medical Research Center for Obstetrics, Gynecology, and Perinatology named after V.I. Kulakov of the Ministry of Health of the Russian Federation; Moscow, Russia, R.I. Safiullin ,   the Department of Andrology and Urology, FSBSI National Medical Research Center for Obstetrics, Gynecology, and Perinatology named after V.I. Kulakov of the Ministry of Health of the Russian Federation; Moscow, Russia, K.S. Guluzade ,   the Department of Obstetrics, Gynecology, Perinatology, and Reproductive Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University of the Ministry of Health of the Russian Federation; Moscow, Russia
Published: May 2024

Introduction. Reconstructive interventions on the male urethra present a complex surgical challenge. It is crucial not only to restore the anatomical patency of the urethra but also patients’ quality of life. The onset of sexual dysfunction after the operation significantly reduces the patients' quality of life and their perception of treatment outcomes. Objective. To conduct a review of the current literature on sexual and reproductive disorders following reconstructive interventions on the male urethra. Material and methods. Literature search was conducted using the PubMed, Google Scholar, and eLibrary databases up to August 2023. The search was performed using keywords in both Russian and English, including urethroplasty, urethral stricture, sexual dysfunction, ejaculatory dysfunction, penile shortening, penile curvature, and cold glans. Results. The development of sexual dysfunction after reconstructive interventions on the urethra depends on anatomical factors, surgical technique, and the extent of urethral involvement. Erectile dysfunction is present within the first 6 months after the surgery, followed by gradual recovery. The development of ejaculatory dysfunction, penile shortening or curvature, as well as impaired sensitivity, depends on the chosen surgical approach. Conclusion. The literature on sexual dysfunction is characterized by heterogeneous studies, making their analysis challenging. Data on reproductive disorders following urethroplasty are presented only in a few studies. To further assess surgical und functional outcomes it is necessary to conduct multicenter studies using validated questionnaires.