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Impact of Urethral Reconstruction on Sexual Function

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Textbook of Male Genitourethral Reconstruction

Abstract

Established beliefs concerning outcomes following anterior urethral reconstruction are changing, both with regards to the genital cosmetics and to the impact on the sexual activity. To-day, the aim of the stricture repair is not only to reinstate urinary function but also to safeguard sexual activity and guarantee genital cosmesis. A thorough evaluation of anterior urethroplasty results should include the sexual viewpoint which appears to play an important role in overall post-operative patient satisfaction. The most commonly reported sexual problems following anterior urethroplasty include: erectile and ejaculatory dysfunction, penile curvature or shortening, dissatisfaction with genital cosmetic appearance and sensorial impairments of glans. The prevalence of specific post-operative sexual problems may be related to the site of reconstruction (penile or bulbar) and to the technique of urethroplasty employed. In penile urethral reconstruction, the wide use of buccal mucosa grafts seems to excel the use of skin flaps which easily distort the cosmesis and elasticity of the penis. In bulbar reconstructions, graft augmentation techniques seem to impact less on sexual outcome than excision anastomotic techniques. Therefore, the policy of primarily indicating an excision anastomotic procedure, whenever possible, should come under scrutiny. Eventual sexual outcomes should be incorporated in the choice of the optimal anterior urethral reconstruction and in pre-operative patient counselling.

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Author information

Authors and Affiliations

  1. Center for Urethral Surgery, Humanitas Institute, Torino, Italy

    Enzo Palminteri & Mirko Preto

  2. Department of Urology, Ghent University Hospital, Ghent, Belgium

    Nicolaas Lumen & Marjan Waterloos

Authors
  1. Enzo Palminteri
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  2. Nicolaas Lumen
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  3. Mirko Preto
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  4. Marjan Waterloos
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Editor information

Editors and Affiliations

  1. School of Medicine, University of Lisbon, Lisbon, Portugal

    Francisco E. Martins

  2. Kulkarni Reconstructive Urology Center, Pune, India

    Sanjay B. Kulkarni

  3. Department of Urology, Mayo Clinic, Rochester, MN, USA

    Tobias S. Köhler

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Palminteri, E., Lumen, N., Preto, M., Waterloos, M. (2020). Impact of Urethral Reconstruction on Sexual Function. In: Martins, F.E., Kulkarni, S.B., Köhler, T.S. (eds) Textbook of Male Genitourethral Reconstruction. Springer, Cham. https://doi.org/10.1007/978-3-030-21447-0_34

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  • DOI: https://doi.org/10.1007/978-3-030-21447-0_34

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-21446-3

  • Online ISBN: 978-3-030-21447-0

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