Impact of simple prostatectomy on erectile function and lower urinary tract symptoms

Abstract

Background: Lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in patients with benign prostatic enlargement (BPE) are common conditions in ageing men. Although the positive impact of surgical management of symptomatic BPE has been established, its impact on erectile function is controversial. This study aimed to determine the impact of open simple prostatectomy on erectile function (EF) and LUTS in patients with BPE.

Methods: This prospective observational study was carried out at our hospital over a period of one year. Consenting patients with clinical, ultrasonic and laboratory features suggesting benign prostate enlargement and who were scheduled for open simple retropubic (Millin’s) prostatectomy were recruited for this study. Patients with elevated serum prostate-specific antigen (PSA) or findings suspicious of prostate cancer on digital rectal examination had prostate biopsies to exclude prostate cancer. The patients were requested to complete the International Prostate Symptoms Score (IPSS) and Sexual Health Inventory for Men (SHIM) questionnaires before the open simple prostatectomy as well as six months after the procedure. The preoperative IPSS and SHIM were compared to postoperative IPSS and SHIM by using the Wilcoxon signed-rank test.

Results: A total of 53 patients took part in the study. Their ages ranged from 44–80 years with a mean of 64 ± 9. The median value of the preoperative IPSS was 29, while the median postoperative value was 2 (p < 0.001). The median value of the preoperative SHIM was 16, while the median postoperative value was 18 (p = 0.6).

Conclusion: There was a significant positive relationship with improvement of LUTS following the simple prostatectomy. There was also slight improvement in erectile function, although it was not statistically significant.