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    Ureteroscopy may adversely affect erectile function

    Worsening of erectile dysfunction score reported by 42% of study patients

    Results of a retrospective study raise concern that ureteroscopy may adversely affect erectile function.

    The research, which was reported at the 2016 World Congress of Endourology in Cape Town, South Africa by urologists from the University of South Florida, Tampa, analyzed change in Sexual Health Inventory for Men (SHIM) severity grade for 38 men who had pre- and post-ureteroscopy data. Twenty-one men (55%) had no ED pre-ureteroscopy (SHIM 22-25), five men had mild ED (SHIM 17-21), mild-moderate (SHIM 12-16) and moderate ED (SHIM 17-21) were each present in two men, and eight men had severe ED (SHIM 22-25).

    At a median follow-up of 37 days after ureterscopy, 16 men (42%) had a worsening of ED score, and half of those men had a worsening of ED grade. ED grade worsening occurred among five men with no ED pre-ureteroscopy (24%; p=.03), two men who had mild ED (40%; p=.40), and one man with moderate ED (50%; p=.422).

    Commentary - URS and ED risk: Intriguing association

    “To our knowledge, this is the first study to investigate whether ureteroscopy may affect erectile function. We were somewhat surprised by the findings considering that we could not find anything else published on this topic, and we recognize that our retrospective study has limitations,” said Bhavik B. Shah, MD, urology resident at the University of South Florida.

    “However, further investigation is warranted to determine if the risk is real because it would be important information for counseling men who are deciding on surgical treatment for nephrolithiasis,” added Dr. Shah, who worked on the study with Rafael Carrion, MD, and colleagues.

    The authors became interested in exploring an association between ureteroscopy and ED when it was observed anecdotally that men were complaining about new-onset ED at a post-ureteroscopy follow-up visit.

    “At first we thought the temporal association was just coincidental, but as the number of these men increased, we thought it was worth seeing if we could find data to corroborate our clinical impression,” Dr. Shah said.

    Patients who present to the University of South Florida stone clinic are asked to complete the SHIM. The 38 men who had pre- and post-ureteroscopy SHIM scores were identified from a total group of 100 men who underwent ureteroscopy between October 2011 and July 2015.

    Next: Limitations include small sample size

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