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The relationship between erectile dysfunction and open urethroplasty: A systematic review and meta-analysis

机译：勃起功能障碍与开放性尿道成形术之间的关系：系统评价和荟萃分析

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Introduction: Various urethroplasty techniques have been used to treat urethral stricture. Whether the patient erectile function is affected by this open surgery is still controversial. Aim: The aim of this study is to determine the relationship between erectile function and open urethroplasty. Methods: A systematic review of the literature was performed using Medline, Embase, the Web of Science, and the Cochrane Library databases through October 2012 to identify articles published in any language that examined the effect of open urethroplasty on the risk of erectile dysfunction (ED). This meta-analysis was conducted according to the guidelines for the meta-analysis of observational studies in epidemiology. Main Outcome Measures: The incidence of ED after urethroplasty. Results: This meta-analysis consisted of 23 cohort studies, which included 1,729 cases. No significant difference was noticed in patients with anterior urethral stricture before or after intervention (odds ratio [OR]=0.86; 95% confidence interval [CI]: 0.52-1.40; P=0.53). While statistical difference in the incidence of ED was revealed in patients before and after intervention for a posterior urethral (OR=2.51; 95% CI: 1.82-3.45; P<0.001), further comparisons demonstrated that most anterior urethroplasties did not have an obvious effect on patient erectile function. However, it seems that the incidence of ED was higher in the bulbar anastomosis group than in the oral graft urethroplasty group (OR=0.32 95% CI: 0.11-0.93; P=0.04). For the posterior urethroplasty, previous operative history did not show a strong relationship with ED. No statistically significant difference in the risk of ED was demonstrated comparing the posterior urethral reconstructive techniques included in this analysis. Conclusion: The adverse effect of urethroplasty itself on erectile function is limited, as more patients recover erectile function after urethral reconstruction. For anterior urethroplasty, bulbar anastomosis might cause a slightly higher incidence of ED than other operations. For posterior urethroplasty, trauma might be the main cause of ED.
机译：简介：各种尿道成形术已被用于治疗尿道狭窄。病人的勃起功能是否受到这种开放手术的影响仍存在争议。目的：本研究的目的是确定勃起功能与开放性尿道成形术之间的关系。方法：截至2012年10月，使用Medline，Embase，Web of Science和Cochrane图书馆数据库对文献进行系统的回顾，以鉴定以任何语言发表的文章，这些文章检查了开放式尿道成形术对勃起功能障碍（ED）风险的影响）。这项荟萃分析是根据流行病学观察性研究的荟萃指南进行的。主要结果指标：尿道成形术后ED的发生率。结果：这项荟萃分析包括23项队列研究，包括1,729例病例。干预前后尿道前狭窄患者无明显差异（比值[OR] = 0.86; 95％置信区间[CI]：0.52-1.40; P = 0.53）。尽管在后尿道介入治疗前后患者的ED发生率有统计学差异（OR = 2.51; 95％CI：1.82-3.45; P <0.001），但进一步的比较表明，大多数前尿道成形术并没有明显的改变。对患者勃起功能的影响。但是，延髓吻合组的ED发病率似乎似乎比口服移植物尿道成形术组高（OR = 0.32 95％CI：0.11-0.93; P = 0.04）。对于后尿道成形术，既往的手术史与ED没有密切关系。与本分析中包括的后尿道重建技术相比，没有证据表明发生ED的风险有统计学上的显着差异。结论：随着越来越多的患者在尿道重建后恢复勃起功能，尿道成形术本身对勃起功能的不良影响是有限的。对于前尿道成形术，延髓吻合术可能会导致ED的发生率比其他手术稍高。对于后尿道成形术，外伤可能是ED的主要原因。

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