Comparison of quality of life and sexual function before and after anterior urethral reconstruction surgery

The study assessed the impact of anterior urethral reconstruction surgery on quality of life and sexual function in 22 male patients with anterior urethral strictures. The mean age was 51 years (range: 25–88), and strictures were localized in the bulbar urethra, penile urethra, or both, with an average stricture length of 4.2 cm. Etiologies included trauma, iatrogenic causes, infections, and idiopathic factors. Surgical techniques included end-to-end urethroplasty, dorsal onlay oral mucosa graft urethroplasty, and combined dorsal graft with ventral augmentation. Significant postoperative improvements were noted in urinary symptoms, with IPSS scores reducing from severe to mild in all patients (p<0.001) and Qmax increasing from a mean of 3.23 ml/s to 19.46 ml/s (p<0.001). Preoperative quality of life, evaluated using EQ-5D and EQ-VAS, showed significant enhancement, with EQ-VAS scores improving from 38.77 to 77.05 (p<0.001). Sexual function, assessed via IIEF-5, remained stable, with no significant postoperative decline (p=0.463), highlighting the preservation of erectile function. USS-PROM evaluations revealed a substantial reduction in symptom severity and improved patient satisfaction. The findings demonstrate that anterior urethral reconstruction effectively restores urinary function and improves quality of life without compromising sexual health, establishing it as a safe and reliable treatment for anterior urethral strictures.