Do Minimally Invasive Benign Prostatic Hyperplasia Treatments Preserve Sexual Function? A Contemporary Review of the Literature

Abstract

Purpose of review: The aim of this study is to compare the sexual function outcomes related to minimally invasive surgical therapies (MISTs) (UroLift^®, Rezum™, Aquablation^®, prostate artery embolization, and iTind^®) for the treatment of benign prostatic hyperplasia (BPH).

Recent findings: Clinical trials and retrospective data evaluating MISTs for BPH have demonstrated improved or stable sexual function outcomes when compared to sham control or transurethral resection of the prostate. Outcomes were assessed at baseline and following treatments using patient-reported outcome measures. Rezum and Aquablation demonstrated preservation of overall ejaculatory function and erectile function at 36-month follow-up. Similar outcomes occurred with UroLift after a 60-month follow-up. Erectile function was preserved following prostate artery embolization and iTIND up to 12 months. MIST for the management of BPH has been demonstrated to be effective in improving urinary function and appears to minimize potential collateral damage on sexual function following treatment.

Keywords: Benign prostatic hyperplasia; Erectile dysfunction; IIEF; MSHQ; Minimally invasive therapy; Sexual dysfunction.