Erectile function mostly not impacted by surgery for benign prostatic hyperplasia

Benign prostatic hyperplasia (BPH) surgery can impact sexual function, mainly involving ejaculatory function, according to a systematic review and meta-analysis recently published in European Urology Focus.

Celeste Manfredi, M.D., from the University of Campania "Luigi Vanvitelli" in Naples, Italy, and colleagues conducted a systematic literature review to assess current evidence regarding the impact of BPH surgery on sexual function. The analysis included 151 studies (20,531 patients).

The researchers found that a pooled analysis of 48 randomized controlled trials (5,045 individuals) showed no statistically significant changes in the International Index of Erectile Function-5 score versus baseline for transurethral resection of the prostate (TURP), laser procedure, and minimally invasive treatment.

There was a higher rate of retrograde ejaculation seen after TURP, other electrosurgical procedures, and the entire laser group. After most minimally invasive procedures, there was no statistically significant increase observed in retrograde ejaculation rate. For prostatic urethral lift, a pooled analysis of Male Sexual Health Questionnaire-Ejaculatory Dysfunction Function scores showed no statistically significant difference between baseline and after treatment, but postoperative Bother scores were significantly higher.

"The ultimate goal of future research should be to improve the evidence on the topic to allow scientific societies to provide clear and strong recommendations, and to ameliorate patient counseling at the moment of therapeutic choice," the authors write.

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