Maintenance of erectile function after photoselective vaporization of the prostate for obstructive benign prostatic hyperplasia.

INTRODUCTION

Photoselective vaporization of the prostate (PVP) with the greenlight laser has become a popular alternative to the standard transurethral resection of the prostate for patients with benign prostatic hyperplasia (BPH). Our initial results of postoperative erectile function are presented.

AIM: To prospectively evaluate the postoperative erectile function of the first 105 consecutive patients undergoing PVP at Texas A&M Health Sciences Center, Scott & White Memorial Hospital, using the Sexual Health Inventory for Men (SHIM) questionnaire.

METHODS

Institutional Review Board approved this case series of 105 consecutive patients who underwent PVP. The men were divided into three groups depending on their preoperative bladder management: Group N-catheter free (N = 86), Group Y-indwelling catheters (N = 8), and Group clean intermittent catheterization (CIC)-performing clean intermittent catheterization (N = 11).

MAIN OUTCOME MEASURES: SHIM scores were obtained and compared preoperatively and at 12-month follow-up visit.

RESULTS

The mean age of the 86 patients in group N, who did not require an indwelling catheter or CIC preoperatively, was 71.8 years. Their mean preoperative SHIM score was 10.7, and was 10.4 postoperatively. The mean age of the eight patients who were in group Y, who did require an indwelling catheter preoperatively, was 76.8. Their mean preoperative SHIM score was 10.5, and improved to 23 postoperatively. The mean age of the 11 patients in group CIC, who performed CIC preoperatively, was 71.8 years. Their mean preoperative SHIM score was 6.0, and was 5.8 postoperatively.

CONCLUSIONS

Sexual function was maintained by patients who underwent PVP for obstructive BPH and who were catheter free or required CIC preoperatively, and was improved for men who had indwelling catheters preoperatively. There was no statistically significant difference between preoperative and postoperative sexual function after PVP for men with either mild or no erectile dysfunction preoperatively.