Avoiding Sexual Dysfunction in BPH Surgery

madman

Member
Abstract

Purpose of Review
To review the prevalence and risks of sexual dysfunction associated with current treatment options for benign prostatic hyperplasia and to characterize techniques and methods to manage postoperative sexual dysfunction related side effects.

Recent Findings
Current surgical therapies available for the treatment of benign prostatic hyperplasia are associated with a substantial risk of both ejaculatory and erectile function. However, many of the novel minimally invasive treatment alternatives have demonstrated the ability to preserve postoperative sexual function to a better degree, all while providing significant relief of lower urinary tract symptoms in an equally safe and efficacious manner.

Summary
Benign prostatic hyperplasia remains a highly prevalent disease among the aging population. While surgical treatments are often necessary to relieve bothersome urinary symptoms, these procedures are associated with an increased risk of sexual dysfunction. As such, there has been an increased interest in the development of minimally invasive therapies, such as the UroLift®, Rezum®, and Aquablation®, with the hopes of achieving similar symptomatic relief while maintaining sexual function. Aside from reporting lower rates of sexual dysfunction, these procedures have also demonstrated comparable safety, durability, and efficacy to current gold standard therapies. Some procedures can even be performed in an outpatient setting, avoiding the need for general anesthesia altogether. Overall, an individualized, shared decision-making approach is necessary to determine the ideal treatment option for each patient.







Conclusions

There has recently been a multitude of innovative surgical technologies for the treatment of BPH and LUTS. TURP remains the gold standard for the treatment of BPH but is associated with high rates of EjD. Thus, patients should be counseled appropriately regarding the potential reduction in postoperative sexual function. Minimally invasive procedures should also be discussed as an alternative, especially in patients who wish to preserve their sexual function. These novel technologies are a promising option to patients and have demonstrated safe, effective, and durable cure to treating BPH symptoms while minimizing sexual dysfunction. Ultimately, as the robust and dynamic field of BPH treatment continues to grow and advance, an individualized, shared decision-making approach among physicians and their patients should be undertaken to select the optimal treatment option for each patient. Regardless of the outcome of the procedure, providers should always be ready to support and assist patients in their journey to recovery.
 

Attachments

marathon man

New Member
Anyone dealing with BPH (Benign Prostatic Hyperplasia)? My doc uses the Olympus Plasma Button Vaporization of Prostate. Has anyone had this done? How long will it lasts and I guess it varies on the individual? As a heavy weight lifter and runner the doctor says I can probably return to my routine in about two to three weeks. I feel that may be far too optimistic. What about ejaculation issues. Wouldn't an enlarged prostate block ejaculation? So I would think the operation to reduce an enlarged prostate should help eljaculation. Anyway, do not like to have to go through an operation so any input appreciated.
 

BrooklynJerry

New Member
I had a TURP done in 2002. The only side effect has been retrograde ejaculation. That took a while to get used to for me. Never had any complaint from my late wife or my GF. I'm 70 now and still can perform pretty good.
 

Joe Sixpack

Active Member
I had a TURP done in 2002. The only side effect has been retrograde ejaculation. That took a while to get used to for me. Never had any complaint from my late wife or my GF. I'm 70 now and still can perform pretty good.
I have a feeling I will be needing a BPH procedure in the near future. Does the orgasm feel the same w/ retrograde? And did you have to use a catheter after the operation?
 

DragonBits

Well-Known Member
IMO I would look at Convective Water Vapor Energy Ablation (Rezum®) or Prostatic Artery Embolization.

I inquired about Prostatic Artery Embolization and a hospital local to chicago does this procedure. Medicare covers is but I asked about self pay costs, they said $7,000 as a all inclusive price if you self pay.

I don't yet need this, but sooner or later there is a good change I will.
 

broker

Active Member
I heard great things about Rezum. My friend had green light laser and is very happy with results. He does get retrograde ejaculation but is now used to it. He says its MUCH better than not being able to fully empty his bladder.
His brother is getting Uro Lift which is a newer procedure and supposedly causes no retrograde at all.
If a doc thinks you need a procedure, get it done. If you continue to strain in order to empy your bladder, you will permanantly damage your bladder.
Turp is used much less today because of better procedures.
 

Profmarvel57

New Member
I suffered from BPH for a long time and didn't want TURP. Finally had holmium laser treatment by Dr. Lingeman in Indianapolis. In the hospital overnight. Retrograde ejaculation but otherwise works fine. Beats getting up 3-4 times a night to hit the john.
 

Joe Sixpack

Active Member
I suffered from BPH for a long time and didn't want TURP. Finally had holmium laser treatment by Dr. Lingeman in Indianapolis. In the hospital overnight. Retrograde ejaculation but otherwise works fine. Beats getting up 3-4 times a night to hit the john.
Yeah, TURP is old school. What made you choose the holmium laser over green light laser or any of the other treatments?
 

Harley

Member
Ciao ,
I think you need to remember that the type of procedure depends on the size of your prostate . Some people with a huge prostate need total removal of the prostate and others with smaller prostate can do with less invasive operations .
I understand it also depends on the shape of the prostate.
 
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