Influence of holmium laser enucleation of the prostate on erectile function: results of a multicentric analysis of 235 patients

• Published in: World journal of urology 2022-11, Vol.40 (11), p.2747-2754
• Main Authors: Deslandes, Maxime, Klein, Clément, Marquette, Thibault, Comat, Vincent, Mallet, Richard, Degraeve, Bertrand, Houssin, Vianney, Villers, Arnauld, Bladou, Franck, Robert, Grégoire
• Format: Article
• Language: English
• Subjects: Enucleation; Hyperplasia; Medicine; Medicine & Public Health; Nephrology; Oncology; Original Article; Patients; Prostate; Prostate cancer; Statistical analysis; Surgery; Urinary tract; Urology
• ISSN: 1433-8726; 0724-4983; 1433-8726
• DOI: 10.1007/s00345-022-04175-0

Purpose Preserved sexual function is one of the endpoints of the surgical management of lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Our aim was to investigate the evolution of erectile function (EF) at 3 and 12 months after holmium laser enucleation of the prostate (HoLEP). Methods A multicentric retrospective study was performed including 235 sexually active patients who underwent HoLEP between January 2016 and June 2017. Evaluation of EF was carried out with the five-item version of the International Index of Erectile Function (IIEF-5) completed before surgery and at 3 and 12 months after surgery. A change of more than five points in either direction in the IIEF-5 score compared to baseline was considered as an improvement or impairment of EF. Results No significant differences were found between median pre-operative IIEF-5 and median scores at 3 and 12 months ( p   =  0.15 and p   =  0.45). At 3 and 12 post-operative months, respectively, 10% and 13% of patients reported an improvement, whereas 15% and 16% reported an impairment. The reduction in IIEF-5 score was only statistically significant within the sub-group of patients with normal pre-operative EF ( p