Change of Sexual Function in Patients Before and After Ho:YAG Laser Enucleation of the Prostate

Abstract

The aim of this study is to evaluate the effect of Ho:YAG laser enucleation of the prostate (HOLEP) to the sexual function of patients with benign prostatic hyperplasia (BPH). In the course of the study, 108 patients with BPH were recruited and accepted treatment with HOLEP. The effectiveness of treatment was evaluated by flow rate and the International Prostate Symptom Score (IPSS) before HOLEP and 6 months afterwards. Meanwhile, the sexual functions were evaluated with the Danish Prostate Symptom Score Sexual Function Questionnaire (DanPSS Sex). Before and 6 months after HOLEP treatment, the mean residual urine volume was reduced from 106.0 +/- 51.7 mL to 5.6 +/- 1.7 mL (P<.01), maximum flow rate was improved from 7.2 +/- 3.9 mL/s to 21.7 +/- 1.3 mL/s (P<.01), nocturia frequency was reduced from 5.5 to 1.5 (P<.01), and the mean IPSS score was decreased from 19.4 +/- 5.6 to 7.4 +/- 2.6 (P<.01). The proportion of patients satisfied with their libido was 55% before HOLEP and 57% 6 months afterwards, while 23.5% of the patients had no libido before and after HOLEP; 37% of the patients were satisfied with their erection before HOLEP and 40% after 6 months; 30% of the patients had completely satisfactory sex life before HOLEP, and 32% did 6 months later. The corresponding percentages of fully impotent patients increased from 33% before the procedure to 35% 6 months postoperation. Early morning erections were reported by 45% of the patients before the procedure and by 62% 6 months later (P<.01). In 70% of the patients with normal sex life, ejaculation was retrograde 6 months after HOLEP (P<.01). HOLEP does not affect the sexual function of patients with BPH but does did improve the ability of early morning erection, while causing retrograde ejaculation.