Impact of benign prostatic hyperplasia surgery on erectile function

We evaluate the prevalence of erectile dysfunction (ED) prior to surgery for benign prostatic hyperplasia (BPH) and changes produced after surgical intervention.

This prospective study included 128 patients treated surgically for BPH. The prevalence of ED was determined before and after surgery according to the International Index of Erectile Function (IIEF). The influence of different clinical variables on erectile function (EF) improvement or deterioration after surgery was determined using uni- and multivariate analyses.

Mean IIEF score before surgery was 20.5 +/- 7.6. Overall, ED was absent in 32% of patients, mild in 42%, moderate in 13.3%, and severe in 12.5%. Mean IIEF score following surgery was 21.5 +/- 7.4 (p = n.s.). After surgery EF improved in 26.6% (34/128) of patients and worsened in 18.8% (24/128) (p < 0.05). Analysing the subset of patients with presurgical ED, 39% reported improvement and 21.1% reported worsening of EF postoperatively. None of the variables analyzed showed a significant relationship with improvement or worsening of EF. Only age was related to worsening EF in the subgroup of non-ED patients.

There is a high prevalence of ED amongst candidates for BPH surgery. Although the risk of worsening EF exists postsurgically, an important percentage of ED patients will improve.