(727) Double-J Ureteral Stent and Sexual Dysfunction: An Underestimated Complication?

Introduction The double-J ureteral stent was first introduced by Zimskind in 1967. However, its widespread use in urological practice dates back to 1978, following its implementation by Dr. Finney. Since then, it has become an essential tool in the management of obstructive uropathy. The most common symptoms associated with ureteral stents include: • Urinary urgency and frequency • Dysuria • Hematuria • Sensation of incomplete bladder emptying • Urinary incontinence • Lumbar or pelvic pain, and pain during sexual intercourse (dyspareunia in women, erectile dysfunction or ejaculatory pain in men) • Urinary tract infections, as the stent acts as a foreign body that may promote bacterial colonization • Emotional and psychological impact: anxiety, depression, or frustration in some patients Objective To evaluate the impact of double-J ureteral stent placement on the sexual function of male and female patients undergoing treatment for ureteral lithiasis. Secondary Objectives • To quantify the impact of the double-J stent on sexual function by sex • To quantify the impact by age group • To assess the incidence of dyspareunia • To assess the incidence of erectile dysfunction • To evaluate the reduction in libido and other parameters of female sexual function Methods Materials and Methods A prospective observational cohort study was conducted involving 100 patients (50 women and 50 men), aged between 18 and 70 years, scheduled for double-J stent placement as part of ureteral lithiasis treatment. The study period spans from January 2024 to January 2025. Upon obtaining informed consent, the following epidemiological data were collected: age, sex, weight, height, sexual orientation, FSH, LH, testosterone, prolactin, urea, creatinine, HDL, LDL, and total cholesterol. Additionally, the International Index of Erectile Function (IIEF) was administered to male participants, and the Female Sexual Function Index (FSFI) to female participants, along with a pain assessment scale. Results The mean age was 51.96 years for men and 52.70 years for women. Statistically significant differences were found between sexes regarding weight and height. Prior to stent placement, 30% of men and 59% of women exhibited sexual dysfunction (p = 0.016). Post-placement, sexual dysfunction was observed in 89% of men and 94% of women. The proportional increase in sexual dysfunction was notably higher in men (59% increase) compared to women (35% increase). Women: Before the procedure, 59% of female patients reported sexual dysfunction, while 41% did not. After stent placement, dysfunction rose to 94%, with only 6% remaining unaffected. The average FSFI score dropped from 18.40 to 7.89, indicating a significant decline in overall sexual function. All FSFI domains were adversely affected. Men: Prior to the procedure, 30% of male patients reported erectile dysfunction, while 70% did not. Following stent placement, 89% experienced sexual dysfunction, leaving only 11% unaffected. Among those previously asymptomatic, 84% developed sexual dysfunction post-placement. All aspects of erectile function were negatively impacted. Pain: Patients aged 41 to 60 years reported more intense pain, whereas younger individuals tended to experience milder discomfort. Conclusions In response to the study objectives, the following conclusions were drawn: 1. Impact on sexual function in both sexes: Negative 2. Impact by sex: More pronounced in men 3. Impact by age: Greater in younger patients of both sexes 4. Impact on pain: More severe in middle-aged patients of both sexes The placement of a double-J ureteral stent has a significant negative impact on sexual function in both male and female patients. Disclosure No