Endourological procedures such as ureterorenoscopy (URS) and double-J (DJ) stenting are effective for ureteric stones but may impact erectile function (EF) and quality of life (QoL) due to procedural discomfort and psychological stress. We prospectively analyse state (S-anxiety) and trait (T-anxiety), as well as its implications for sexual health and overall well-being and its influence in postoperative recovery.

In this prospective cohort study,150 patients undergoing URS or DJ stenting were assessed using the International Index of Erectile Function (IIEF-5),State-Trait Anxiety Inventory (STAI), and WHOQOL-BREF. Assessments were done preoperatively and at 2 weeks,1,3,and 6 months postoperatively.Univariate and multivariate regression analyses identified predictors of EF and QoL.

IIEF-5 scores declined significantly at 2 weeks post-op (11.09 ± 4.92 vs. 14.31 ± 6.43 pre-op, p < 0.001),then improved by 3 months (15.75 ± 4.04) and stabilized at 6 months (16.07 ± 4.20, p = 0.001). S-anxiety negatively correlated with EF at all time points (pre-op: r = -0.889, p < 0.001);T-anxiety showed weak positive correlation at 6 months (r = 0.368, p < 0.001). Severe S-anxiety (aOR = 3.20, p < 0.001) and T-anxiety (aOR = 2.90, p = 0.001) independently predicted ED. QoL improved significantly by 6 months, from 71.80 ± 15.80 to 97.80 ± 6.20 (p < 0.05). Shorter stent durations (≤2 weeks) and alpha-blockers were linked to better QoL.

Anxiety, especially S-anxiety, significantly affects EF after URS and DJ stenting. A holistic perioperative approach incorporating psychological support and optimized stent protocols can enhance EF and QoL outcomes.