Can photoselective vaporization of the prostate affect erectile function?

Marc B. Garnick, MD
Hematology & Oncology
Photoselective vaporization of the prostate (PVP) has become a popular treatment option for benign prostatic hyperplasia (BPH), or enlarged prostate. It uses lasers to destroy excess prostate tissue and improve urine flow. But a French study suggests that the minimally invasive procedure may impair erectile function.

Researchers followed 149 men who had PVP, assessing their sexual function with questionnaires preoperatively, every three months for a year postoperatively, and then yearly for up to four years. They also measured patients' urinary function and collected other data, such as PSA levels.

As expected, PVP significantly improved patients' urine flow. For the group as a whole, it didn't significantly alter erectile function. However, patients who had normal sexual function before the procedure reported that it declined significantly after PVP.

The reasons for this decline are unclear, but the researchers speculate that diffusion of the laser's power in certain areas may be to blame. They also note that study participants with normal erectile function may have been healthier than the group as a whole. But researchers did not account for the potential impact of other health problems on erectile function.

Researchers need to follow more patients before making definitive conclusions about PVP's long-term effects on erectile function. For now, patients seeking treatment for BPH who are concerned about erectile function should discuss their options with their doctors.

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