COMPARISON OF SEXUAL FUNCTION AFTER RETROGRADE INTRARENAL SURGERY AND URETEROSCOPY: A RETROSPECTIVE COHORT STUDY

Öz

Objective: Retrograde intrarenal surgery (RIRS) and ureteroscopy (URS) are widely adopted minimally invasive techniques for treat ing upper urinary tract stones. However, their comparative effects on sexual function remain poorly understood. This study aimed to compare the impact of RIRS versus URS on sexual function and identify risk factors for prolonged dysfunction. Material and Methods: In this retrospective cohort study, we analysed 360 propensity scorematched patients (180 pairs) who underwent RIRS or URS between January and December 2022. Sex ual function was assessed using validated questionnaires (IIEF5, PEDT, MSHQ for males; FSFI, OABq SF for females) at baseline and 3, 6, and 12 months postoperatively. The primary outcome was the change in sexual function scores; the secondary outcomes included the recovery time and complication rates. Results: RIRS patients showed significantly greater decreases in sexual function scores at 3 months (mean difference: −2.8 points, 95% CI: −3.9 to −1.7, p<0.001), with effects diminishing by 12 months. Recovery rates were higher in the URS group (94.2% vs 89.7%, p=0.008). Age >60 years (HR: 2.3, 95% CI: 1.83.1) and stones >15 mm (HR: 2.2, 95% CI: 1.72.9) were independent predictors of prolonged recovery. Stonefree rates (82.0% vs 84.9%) and complications (10.5% vs 14.1%) were comparable between the groups. Conclusion: RIRS is associated with a more pronounced but temporary impact on sexual function compared with URS. These f indings can inform preoperative counselling and procedure selec tion for highrisk patients.

Anahtar Kelimeler

• Retrograde intrarenal surgery
• ureteroscopy
• sexual dys function
• urolithiasis
• endourology

RETROGRAD İNTRARENAL CERRAHİ VE ÜRETEROSKOPİ SONRASI CİNSEL İŞLEVİN KARŞILAŞTIRILMASI: RETROSPEKTİF KOHORT ÇALIŞMASI

Öz

Amaç: Retrograd intrarenal cerrahi (RIRC) ve üreteroskopi (URS), üst üriner sistem taşlarının tedavisinde yaygın olarak kullanılan minimal invaziv tekniklerdir. Ancak, bu prosedürlerin cinsel fonksiyon üzerindeki karşılaştırmalı etkileri yeterince anlaşılamamıştır. Bu çalışma, RIRC ve URS’nin cinsel fonksiyon üzerindeki etkilerini karşılaştırmayı ve uzamış disfonksiyon için risk faktörlerini belirlemeyi amaçlamıştır. Gereç ve Yöntemler: Bu retrospektif kohort çalışmasında, Ocak Aralık 2022 tarihleri arasında RIRC veya URS uygulanan propensity skor eşleştirilmiş 360 hasta (180 çift) analiz edildi. Cinsel fonksiyon, valide edilmiş anketler kullanılarak (erkekler için IIEF5, PEDT, MSHQ; kadınlar için FSFI, OABq SF) başlangıçta ve postoperatif 3, 6 ve 12. aylarda değerlendirildi. Primer sonlanım noktası cinsel fonksiyon skorlarındaki değişim; sekonder sonlanım noktaları iyileşme süresi ve komplikasyon oranlarıydı. Bulgular: RIRC hastalarında 3. ayda cinsel fonksiyon skorlarında anlamlı düşüş gözlendi (ortalama fark: −2,8 puan, %95 GA: −3,9 ile −1.7, p<0,001), bu etki 12. ayda azaldı. İyileşme oranları URS grubunda daha yüksekti (%94,2′ye karşı %89.7, p=0,008). 60 yaş üstü (HR: 2,3, %95 GA: 1,83,1) ve 15 mm üzeri taşlar (HR: 2,2, %95 GA: 1,72,9) uzamış iyileşmenin bağımsız prediktörleriydi. Taşsızlık oranları (%82,0′ye karşı %84,9) ve komplikasyonlar (%10,5′e karşı %14,1) gruplar arasında benzerdi. Sonuç: RIRC, URS’ye kıyasla cinsel fonksiyon üzerinde daha belirgin ancak geçici bir etkiye sahiptir. Bu bulgular, yüksek riskli hastalarda preoperatif danışmanlık ve prosedür seçimine yön verebilir

Anahtar Kelimeler

• Retrograd intrarenal cerrahi
• üreteroskopi
• cinsel işlev bozukluğu
• ürolitiyazis
• endoüroloji

Kaynakça

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