Introduction

The surgical intervention in patients with the lower urinary tract symptoms (LUTS) caused by benign prostatic hyperplasia (BPH) may affect the sexual function; however modern approaches to treatment (enucleation techniques) may preserve sexual function. Holmium laser enucleation of the prostate (HoLEP) is one of them. _x000D_ The aim of the study was to evaluate the sexual and erectile function in patients with benign prostatic hyperplasia who were subjected to HoLEP.

Methods

Four hundred and fifty-nine patients with benign prostatic hyperplasia (mean age 68.7 years) who experienced holmium laser enucleation of the prostate participated in the study. All the patients were tested according to the International Index of Erectile Function (IIEF) to assess their sexual function, and the IPSS ? QoL scores were also determined for all the patients to evaluate the results of the operation.

Results

The patient's erectile function, ejaculation, sexual desire, and the general satisfaction with sexual intercourse were evaluated according to the IIEF. All the patients were examined both before surgery and 6 and 12 months after the operation. It is important to note that most parameter values remained virtually unchanged, although the ejaculation quality score decreased due to retrograde ejaculation in 297 patients (64.7%). _x000D_ Note that all the patients reported better satisfaction with sexual intercourse (from 22.1 to 23.3) that correlated with an improvement in the QoL and IPSS scores. The number of patients with complaints of erectile disorders was not increased. The effect of this surgical intervention was more pronounced in the group of patients with more severe pre-existing erectile dysfunction. _x000D_ _x000D_ _x000D_

Conclusions

HoLEP results in a significant improvement in the IPSS, QoL and does not influence the values pertaining to the erectile function (IIEF). Despite the occurrence of postoperative retrograde ejaculation in a large percentage of patients, most of them did not regard this complication as significant, which was evidenced by higher QoL and IIEF scores in the postoperative period compared with the preoperative findings. These facts allow us to characterize HoLEP as a technique that helps to preserve and, in certain cases, to improve the erectile and sexual function in patients with benign prostatic hyperplasia.

Funding

none