There is a high incidence of sexual dysfunction after urethral stricture reconstruction surgery, with a particular predominance of erectile dysfunction. However, few studies have been conducted in this area. We retrospectively analyzed patients who underwent urethral reconstruction surgery for anterior urethral stricture between August 2000 and October 2004, and assessed their sexual function before and after surgery using the Male Sexual Function Simplified Scale (BMFSI) 4 months after surgery. 2 questions on ejaculatory function, 2 questions on sexual urge, and 3 questions on erectile function in the BMFSI questionnaire, with scores from 0 to 4 indicating function from the worst to the best. Patients were grouped by age according to the O’Leary method in three groups: 40 to 49 years, 50 to 59 years, and greater than 60 to 69 years, with patients younger than 40 years classified in the 40 to 49 years group. 52 of 76 patients (68%) completed the BMFSI questionnaire and had a total history of 59 urethral reconstruction procedures. The surgical procedures included end-to-end anastomosis of the bulb urethra (23 cases, 44%), dorsal or ventral oral mucosal replacement of the urethra (22 cases, 42%), and second-stage oral mucosal reconstruction of the urethra (7 cases, 14%). As for those with second-stage surgery, only before and after the second surgery were evaluated. The mean follow-up time (SD) was 22.3 months (14.8), and the mean length of urethral repair (SD) was 4.85 (3.1) cm. the length of stenosis for end-to-end urethral anastomosis, and for second-stage oral mucosal replacement was 2.5 (0.7) cm, and 7.8 (1.5) cm, respectively, with a significant difference, p<0.02. sexual urge and erectile function before and after surgery There was no statistically significant difference. By age group, erectile function (sd) was significantly decreased before and after surgery in patients aged 50 to 59 years, 9.5 (2.3), 8.8 (2.5), respectively, p<0.001. Patients over 60 years were similar to the group aged 50 to 59 years, 4.3 (2.9), 2.9 (2.4), respectively, but not statistically significant, p=0.05. Younger group under 49 years before and after surgery There was no change in erectile function. Patients with decreased postoperative erectile function recovered with time, so it is unlikely that a decrease in erectile function due to surgery would be reported in patients more than 1 year postoperatively. Ejaculatory function was significantly improved in all patients postoperatively (p=0.04), and if grouped by age, only patients younger than 49 years had significantly improved ejaculatory function. The results of multifactorial analysis showed that the surgical side of urethral stricture repair (p=0.91,p=0.54,p=0.36), stricture length (p=0.17,p=0.98,p=0.72) did not significantly affect erectile function, sexual urge, or ejaculatory function. < span="">Comments Current research on sexual function with anterior urethral stricture reconstruction surgery has focused on erectile function, but as the complexity of sexual function is progressively understood, it is beginning to be recognized that satisfactory sexual function is more than just obtaining a satisfactory erection. In order to allow for a multifaceted assessment of male sexual function and sexual satisfaction after urethral reconstruction surgery, the BMFSI scale is a standard and validated questionnaire that was originally designed to detect changes in erectile function, sexual urge, and ejaculatory function before and after urological interventions. A drawback of this study is that the preoperative assessment was scored by recall, which may be biased. Nevertheless, the BMFSI questionnaire remains a simple and reliable tool to assess sexual function after urethral reconstruction.