Indwelling ureteral stenting negatively impacts sexual function transiently after endourological procedure among adult male and female patients: a prospective cohort study

Main Article Content

Ferdy Bangun Kangsaputra
Nur Budiyono
Sakti Ronggowardhana Brodjonegoro

Abstract

Background
Ureteral stents, which are widely used after endourological procedures, cause adverse effects. However, its potential impact on sexual function remains unclear in patients undergoing ureteral stenting. This study aimed to investigate sexual function in adult male and female patients undergoing endourological procedures involving ureteral stent placement.


Methods
We conducted a prospective cohort study in a double tertiary care hospital setting with 103 selected patients (53 male and 50 female). We used a self-administered questionnaire-based survey, namely the Indonesian version of the 5-item International Index of Erectile Function (IIEF-5) for male patients and the Indonesian Female Sexual Function Index (Indonesian FSFI) for female patients at three different times (pre-stenting, four weeks after stenting, and four weeks after stent removal). A paired t-test or Wilcoxon test was used for data analysis.


Results
In the male group, significant changes were noted in the four IIEF-5 domains and overall IIEF-5 scores at pre-stenting and four weeks after stenting (p =0.000). The female group showed significant differences for all FSFI domains and overall FSFI scores at pre-stenting and four weeks after stenting (p=0.000). Most patients in both groups recovered sexual function four weeks after stent removal, as indicated by insignificant differences in the overall IIEF-5 and FSFI scores at pre-stenting and four weeks after stent removal.


Conclusion
Ureteral stenting led to significant but transient sexual dysfunction in both groups at four weeks after stenting. In this regard, male and female patients need to receive counselling and attention, that they may experience temporal sexual dysfunction at least for 4 weeks.

Article Details

How to Cite
Kangsaputra, F. B., Budiyono, N., & Brodjonegoro, S. R. (2023). Indwelling ureteral stenting negatively impacts sexual function transiently after endourological procedure among adult male and female patients: a prospective cohort study. Universa Medicina, 42(3), 276–282. https://doi.org/10.18051/UnivMed.2023.v42.276-282
Section
Original Articles
Author Biographies

Nur Budiyono, Urology Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Bulaksumur, Yogyakarta, Indonesia

 

 

Sakti Ronggowardhana Brodjonegoro, Urology Division, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Gadjah Mada University, Bulaksumur, Yogyakarta, Indonesia

 

 

References

World Health Organization. Sexual health, human rights and the law. Geneva: World Health Organization; 2015.

Santosa A, Ohman A, Högberg U, Stenlund H, Hakimi M, Ng N. Cross-sectional survey of sexual dysfunction and quality of life among older people in Indonesia. J Sex Med 2011;8:1594-602. doi: 10.1111/j.1743-6109.2011.02236.x.

Zimskind PD, Fetter TR, Wilkerson JL. Clinical use of long-term indwelling silicone rubber ureteral splints inserted cystoscopically. J Urol 1967;97:840-4. doi: 10.1016/S0022-5347(17)63130-6.

Ehsanullah SA, Bruce A, Juman C, et al. Stent diameter and stent-related symptoms, does size matter? A systematic review and meta-analysis. Urol Ann 2022;14:295-302. doi: 10.4103/ua.ua_158_21.

Lu J, Lu Y, Xun Y, Chen F, Wang S, Cao S. Impact of endourological procedures with or without double-J stent on sexual function: a systematic review and meta-analysis. BMC Urol 2020;20:13. https://doi.org/10.1186/s12894-020-0582-1.

Zhu C, Qu J, Yang L, Feng X. The Chinese linguistic validation of the ureteral stent symptom questionnaire. Urol Int 2019;102:194-8. doi: 10.1159/000493764.

Tanidir Y, Mangir N, Sahan A, Sulukaya M. Turkish version of the Ureteral Stent Symptoms Questionnaire: linguistic and psychometric validation. World J Urol 2017 ;35:1149-54. doi: 10.1007/s00345-016-1958-4.

Arora A, Sane MS, Jadhao V, Maheshwari PN. Sexual dysfunction in Indian men undergoing Double J ureteral stenting following ureteroscopy -A prospective analysis. Andrologia 2020;52: e13790. doi: 10.1111/and.13790.

Bolat MS, Akdeniz E, Asci R, Erdemir F, Cinar O, Tomak L. Ureterorenoscopy with stenting and its effect on male sexual function: a controlled randomised prospective study. Andrologia 2017;49. doi: 10.1111/and.12746.

Laksita TB, Kloping YP, Hakim L, Rizaldi F. Translation validity and reliability of the Indonesian version of the 5-item International Index of Erectile Function (IIEF-5). Turk J Urol 2021;47:489-94. doi: 10.5152/tud.2021.21185.

Nuring P, Iman SB, Denny A, Ova E. Validation test of Indonesian female sexual function index (Indonesian FSFI). Bali Med J 2019;8:164-8. DOI:10.15562/bmj.v8i1.1138.

Widyokirono DR, Kloping YP, Rahman ZA, Hakim L. Outcomes of ureteral stent placement for hydronephrosis in patients with ureteral stone. Univ Med 2021;40:226-233. doi: 10.18051/UnivMed.2021.v40. 226-23.

Kazmi Z, Umer D, Ather MH. The effect of ureteric stenting on female sexual function: a prospective cohort study. Cureus 2020;12. doi: 10.7759/cureus. 11075.

Eryildirim B, Tuncer M, Sahin C, Yucetas U, Sarica K. Evaluation of sexual function in patients submitted to ureteroscopic procedures. Int Braz J Urol 2015;41:791-5. doi: 10.1590/S1677-5538. IBJU.2014.0353.

Leibovici D, Cooper A, Lindner A, Ostrowsky R, Kleinmann J. Ureteral stents: morbidity and impact on quality of life. Isr Med Assoc J 2005;7: 491-4.

Reddy SJ, Reddy BS, Chawla A, et al. Outcomes and complications from a randomized controlled study comparing conventional stent placement versus no stent placement after ureteroscopy for distal ureteric calculus <1 cm. J Clin Med 2022;11: 7023. doi: 10.3390/jcm11237023.

Mosharafa A, El Hamid MA, Tawfik M, El Rzzak OA. Effect of endourological procedures on erectile function: a prospective cohort study. International urology and nephrology. Int Urol Nephrol 2016;48:1055-9. doi: 10.1007/s11255-016-1274-3. 016-1274-3.

Akdeniz E, Bolat MS, Asci R. Ureterorenoscopy with stenting and its effect on female sexual function. Urol J 2017;14:3059-63. Erratum in: Urol J 2020;17:432. Asci Ramazan [added].

Eryildirim B, Tuncer M, Kuyumcuoglu U, Faydaci G, Tarhan F, Ozgu A. Do ureteral catheterisation procedures affect sexual functions? A controlled prospective study. Andrologia 2011;419–23.doi: 10.1111/j.1439-0272.2011.01199.x

Falahatkar R. The effects of pregabalin, solifenacin and their combination therapy on ureteral double-J stent-related symptoms: a randomized controlled clinical trial. Int Braz J Urol 2021;47:596–609. doi: 10.1590/S1677-5538.IBJU.2020.084821.

Morselli S, Liaci A, Nicoletti R, et al. The use of a novel smartphone app for monitoring male luts treatment during the COVID-19 outbreak. Prostate Cancer Prostatic Dis 2020;23:724-6. doi: 10.1038/s41391-020-0253-z.

Dasgupta R, Ong TA, Lim J, et al. A global perspective of stenting after ureteroscopy: an observational multicenter cohort study. Soc Int Urol J 2021;2:96–105. doi: https://10.48083/HRLS8587.