Beyond symptom relief: quality of life after surgery for benign prostatic obstruction

Surgery for benign prostatic obstruction (BPO) usually provides substantial relief of lower urinary tract symptoms (LUTS), yet conventional functional measures capture only part of what matters to patients. This scoping review mapped how surgical and minimally invasive treatments influence quality of life (QoL) within a multidimensional, patient-centred framework.

A systematic search of PubMed, Scopus, and Google Scholar was performed on July 12, 2026, using predefined keywords. Eligible studies included English-language peer-reviewed articles involving adult patients undergoing surgical treatment for LUTS/BPO secondary to benign prostatic hyperplasia who were evaluated for QoL and patient-reported outcomes. Case reports, reviews, conference abstracts, and non-English publications were excluded. Screening was performed independently by two reviewers, with disagreements resolved by a third.

Disease-specific QoL improved after transurethral resection, endoscopic enucleation, vaporization, Aquablation, and minimally invasive treatments. HoLEP/EEP and GreenLight offered urinary benefit broadly comparable with TURP while differing in selected perioperative outcomes. Aquablation and PUL were more clearly distinguished by ejaculation preservation and recovery, whereas PAE achieved less deobstruction. Persistent storage symptoms or transient incontinence could delay recovery, and long-term evaluation depended on independence from catheter and medication and the need for retreatment.

IPSS-QoL alone cannot adequately describe QoL after BPO surgery. Combining urinary bother with storage function, continence, sexual health, recovery, durability, and satisfaction provides a more meaningful account of treatment success and may support more individualized procedure selection.