title: The impact of minimally invasive surgeries for the treatment of symptomatic benign prostatic hyperplasia on male sexual function: a systematic review.
abstract: A systematic review of randomized controlled trials and cohort studies was conducted to evaluate data for the effects of minimally invasive procedures for treatment of symptomatic benign prostatic hyperplasia (BPH) on male sexual function. The studies searched were trials that enrolled men with symptomatic BPH who were treated with laser surgeries, transurethral microwave therapy (TUMT), transurethral needle ablation of the prostate (TUNA), transurethral ethanol ablation of the prostate (TEAP) and high-intensity frequency ultrasound (HIFU), in comparison with traditional transurethral resection of the prostate (TURP) or sham operations. A total of 72 studies were identified, of which 33 met the inclusion criteria. Of the 33 studies, 21 were concerned with laser surgeries, six with TUMT, four with TUNA and two with TEAP containing information regarding male sexual function. No study is available regarding the effect of HIFU for BPH on male sexual function. Our analysis shows that minimally invasive surgeries for BPH have comparable effects to those of TURP on male erectile function. Collectively, less than 15.4% or 15.2% of patients will have either decrease or increase, respectively, of erectile function after laser procedures, TUMT and TUNA. As observed with TURP, a high incidence of ejaculatory dysfunction (EjD) is common after treatment of BPH with holmium, potassium-titanyl-phosphate and thulium laser therapies (> 33.6%). TUMT, TUNA and neodymium:yttrium aluminum garnet visual laser ablation or interstitial laser coagulation for BPH has less incidence of EjD, but these procedures are considered less effective for BPH treatment when compared with TURP.
authors.affiliation: Division of Urology, University of Texas Medical School at Houston, Houston, TX 77030, USA.
authors.forename: Ryan W
authors.initials: RW
authors.lastname: Frieben
authors.forename: Hao-Cheng
authors.initials: HC
authors.lastname: Lin
authors.forename: Peter P
authors.initials: PP
authors.lastname: Hinh
authors.forename: Francesco
authors.initials: F
authors.lastname: Berardinelli
authors.forename: Steven E
authors.initials: SE
authors.lastname: Canfield
authors.forename: Run
authors.initials: R
authors.lastname: Wang
mesh_terms: D004542:Ejaculation; D007172:Erectile Dysfunction / Q000209:etiology; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects; D008297:Male; D008872:Microwaves / Q000009:adverse effects; D019060:Minimally Invasive Surgical Procedures; D010410:Penile Erection / Q000502:physiology*; D011468:Prostatectomy / Q000379:methods; D011470:Prostatic Hyperplasia / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic; D020728:Transurethral Resection of Prostate / Q000009:adverse effects
references.citation: Eur Urol. 2004 Oct;46(4):496-501; discussion 501-2
references.pmid: 15363567
references.citation: Urology. 1998 Jan;51(1):19-28
references.pmid: 9457283
references.citation: J Urol. 1999 Aug;162(2):383-6
references.pmid: 10411043
references.citation: J Urol. 2000 Jun;163(6):1730-3
references.pmid: 10799170
references.citation: Minerva Urol Nefrol. 2009 Sep;61(3):269-89
references.pmid: 19773728
references.citation: Eur Urol. 2008 Oct;54(4):902-7
references.pmid: 18502565
references.citation: Br J Urol. 1996 Sep;78(3):398-400
references.pmid: 8881949
references.citation: J Sex Med. 2010 Jan;7(1 Pt 2):374-88
references.pmid: 20092445
references.citation: BJU Int. 2002 Dec;90(9):853-62
references.pmid: 12460345
references.citation: J Endourol. 1994 Jun;8(3):217-9
references.pmid: 7524916
references.citation: Asian J Androl. 2008 Jan;10(1):45-53
references.pmid: 18087643
references.citation: J Endourol. 1999 Mar;13(2):127-30
references.pmid: 10213108
references.citation: J Urol. 2004 Jun;171(6 Pt 1):2336-40
references.pmid: 15126816
references.citation: J Endourol. 2000 Nov;14(9):757-60
references.pmid: 11110572
references.citation: J Urol. 2004 Nov;172(5 Pt 1):1926-9
references.pmid: 15540757
references.citation: BJU Int. 2009 Feb;103(3):352-6
references.pmid: 18778340
references.citation: J Urol. 2000 Oct;164(4):1206-11
references.pmid: 10992367
references.citation: J Urol. 1998 May;159(5):1588-93; discussion 1593-4
references.pmid: 9554360
references.citation: J Endourol. 2006 Aug;20(8):580-5
references.pmid: 16903819
references.citation: J Urol. 1996 Jan;155(1):181-5
references.pmid: 7490827
references.citation: Urology. 2008 Feb;71(2):247-51
references.pmid: 18308094
references.citation: Urology. 1995 Aug;46(2):155-60
references.pmid: 7542818
references.citation: Eur Urol. 2008 Feb;53(2):382-89
references.pmid: 17566639
references.citation: Eur Urol. 2006 Sep;50(3):569-73
references.pmid: 16704894
references.citation: Int J Clin Pract. 2005 May;59(5):579-90
references.pmid: 15857355
references.citation: Urology. 2007 Jan;69(1):91-6; discussion 96-7
references.pmid: 17270624
references.citation: J Urol. 2003 Oct;170(4 Pt 1):1270-4
references.pmid: 14501739
references.citation: J Endourol. 2003 Mar;17(2):103-7
references.pmid: 12689404
references.citation: J Urol. 2006 May;175(5):1817-21
references.pmid: 16600770
references.citation: Urology. 2002 Aug;60(2):305-8
references.pmid: 12137831
references.citation: J Urol. 2004 Aug;172(2):616-9
references.pmid: 15247745
references.citation: J Urol. 2004 Sep;172(3):1012-6
references.pmid: 15311026
references.citation: J Androl. 2007 Mar-Apr;28(2):259-61
references.pmid: 17021335
references.citation: Br J Urol. 1997 Feb;79(2):181-5
references.pmid: 9052467