Effect of endourological procedures on erectile function: a prospective cohort study

Many patients offered endourological procedures are concerned about potential sexual dysfunction following endoscopy, and there are scarce published data to support an evidence-based response. We aim to assess possible effects of endourological procedures on sexual activity and erectile function.

Sexually active men undergoing cystoscopy and/or upper tract endourological procedures were enrolled and evaluated using the IIEF-5 score and the IPSS, filled the day before and 10 days and 45–60 days after the procedure. Patients’ characteristics (age, chronic medical condition, smoking, and medications) were recorded. The primary outcome was the change in the IIEF-5 score.

One hundred patients aged 24–60 years (mean 37.4) underwent endourological procedures (42 PCNLs, 30 ureteroscopies, 22 retrograde ureteropyelographies ± stenting, and 6 cystolitholapaxies) between January and August 2014. Preoperative IPSS ranged from 0 to 32 (mean [SD] 11.93 [8.64]), while IIEF-5 ranged from 14 to 25 (mean [SD] 21.63 [2.96]), with eight patients in the mild to moderate (12–16) ED range, 31 mild ED (17–21), and 59 no ED (22–25). Following the procedure, the IPSS improved (mean IPSS down from 11.9 to 6.1 at 10 days and 6.2 at 45 days, P < 0.001), while the IIEF remained unchanged [21.6 preoperative to 21.0 at 10 days (P = 0.43) and 21.7 at 45 days (P = 0.81)]. Patients with indwelling ureteric stents (28 patients) had significant LUTS postoperatively with a mean [SD] IPSS of 9.8 [7.2] at 10 days and 11.6 [7.8] at 45 days. The IIEF-5 score was not affected with a mean [SD] of 21.5 [3.3] at 10 days and 21.8 [3.1] at 45 days, compared to 22.0 [3.0] preoperatively (P = 0.44).

Endoscopic procedures did not negatively impact erectile function and sexual activity.