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Related Experiment Video

Updated: Nov 2, 2025

Retzius-Sparing Robot-Assisted Radical Prostatectomy

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Published on: May 19, 2022

Erectile Function Following Surgery for Benign Prostatic Obstruction: A Systematic Review and Network Meta-analysis

Alexander Light¹, Dost Jabarkhyl², Peter Gilling³

¹Department of Surgery, University of Cambridge, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

European Urology

|June 15, 2021

Summary

This summary is machine-generated.

Prostatic urethral lift (PUL) shows potential for improving erectile function in men with benign prostatic obstruction (BPO) compared to traditional surgery. Further research is needed to confirm these findings and compare PUL with other advanced BPO treatments.

Keywords:

Benign prostatic hyperplasia Benign prostatic obstruction Ejaculation Ejaculatory dysfunction Erectile dysfunction Erectile function International Index of Erectile Function-5 Network meta-analysis Prostatic urethral lift Sexual function

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Area of Science:

Urology
Sexual Medicine
Surgical Innovation

Background:

Benign prostatic obstruction (BPO) frequently coexists with sexual dysfunction.
Surgical interventions for BPO can significantly impact erectile function.

Purpose of the Study:

To systematically review and network meta-analyze randomized controlled trials (RCTs) evaluating the impact of BPO interventions on erectile function.
To compare the efficacy of various BPO treatments concerning postoperative erectile function.

Main Methods:

Systematic search of three databases for RCTs comparing surgical interventions for BPO.
Network meta-analysis using a random-effects Bayesian model to assess postoperative International Index of Erectile Function-5 (IIEF-5) scores.
Meta-regression analysis to explore the influence of baseline scores and heterogeneity.

Main Results:

Prostatic urethral lift (PUL) demonstrated a trend towards improved erectile function at 24 months compared to monopolar transurethral resection (mTURP), reaching statistical significance (MD 3.63, 95% CrI 0.14 to 7.11).
No other interventions showed statistically significant differences in erectile function up to 60 months.
High heterogeneity was observed, particularly at 1 and 60 months.

Conclusions:

PUL may offer benefits for erectile function in BPO patients at 24 months post-procedure compared to mTURP, though direct evidence is limited.
Current evidence does not support significant differences in erectile function for other BPO interventions up to 5 years.
Further high-quality RCTs are recommended to compare PUL with other surgical options like holmium laser or bipolar enucleation regarding sexual function outcomes.