Objective: Aim of this study is to identify risk factors associated with erectile dysfunction in post-transurethral prostate resection (TURP) patients for the management of benign prostatic hyperplasia (BPH). Material & Methods: During 2019, 22 patients met the TURP indication criteria in the urology polyclinic of Koja Hospital for symptomatic BPH management. All patients underwent transabdominal ultrasonography to confirm prostate volume and underwent laboratory tests to measure serum prostate-specific antigen (PSA). History of comorbidities such as diabetes mellitus, cardiovascular events, and hypertension was recorded. The patient's sexual function was determined using the International Index of Erectile Function questionnaire (IIEF-5) before surgery and six months postoperatively, where erectile dysfunction was established for scores below 21. Mean comparisons were made to see if there was a significant change in IIEF score six months postoperatively. Results: There were 22 subjects as samples with a mean age of 63 ± 3.8 years, prostate volume 47.64 ± 5.5 mL and a median PSA level of 3.3 [1-47] ng/dL. The comorbidities found in the subjects were diabetes mellitus (22.7%), cardiovascular events (36.4%), and hypertension (27.3%). The mean IIEF-5 score before surgery was 14.55 ± 0.78 and was not significantly different (p= 0.225) with a reevaluation six months after surgery of 14.18 ± 0.76. Conclusion: There was no change in the severity of erectile dysfunction in patients undergoing TURP surgery.
Erectile dysfunction, TURP, BPH
Feldman HA, Goldstein I, Hatzichristou DG, Krane RJ, McKinlay JB. Impotence and its medical and psychosocial correlates: results of the Massachusetts Male Aging Study. J Urol 1994; 151: 54–61.
Tsitouras PD, Martin CE, Harman SM. Relationship of serum testosterone to sexual activity in healthy elderly men. J Gerontol 1982; 37: 288–93.
Paick SH, Meehan A, Lee M, Penson DF, Wessells H. The relationship among lower urinary tract symptoms, prostate specific antigen and erectile dysfunction in men with benign prostatic hyperplasia: results from the proscar long-term efficacy and safety study. J Urol 2005; 173: 903–7.
van Dijk M, Skrekas T, de la Rosette JJ. The association between lower urinary tract symptoms and sexual dysfunction: fact or fiction? Curr Opin Urol 2005; 15: 39–44.
Chung WS, Nehra A, Jacobson DJ, Roberts RO, Rhodes T, Girman CJ, et al. Lower urinary tract symptoms and sexual dysfunction in community-dwelling men. Mayo Clin Proc 2004; 79: 745–9.
US Department of Health and Human Services. Benign Prostatic Hyperplasia: Diagnosis and Treatment. Bethesda MD: Agency for Health Care Policy and Research; 1994.
Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Pena BM. Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF–5) as a diagnostic tool of erectile dysfunction. Int J Impot Res 1999; 11: 319–26.
STSC PLUS*WARE software product. Statgraphics User’s Guide. Rockville, MD: STSC; 1986.
Armitage P, Berry G, Matthews JNS. Statistical Methods in Medical Research. Melbourne: Blackwell Publishing: 2002. P162.
Lindner A, Golomb J, Korczak D, Keller T, Siegel Y. Effects of prostatectomy on sexual function. Urology 1991; 38: 26–8.
Soderdahl D, Knight R, Hansberry K. Erectile dysfunction following transurethral resection of the prostate. J Urol 1996; 156: 1354–6.
Tscholl R, Largo M, Poppinghaus H, Recker F, Subotic B. Incidence of erectile impotence secondary to transurethral resection of benign prostatic hyperplasia, assessed by preoperative and postoperative Snap Gauge tests. J Urol 1995; 153: 1491–3.
Hanbury D, Sethia K. Erectile function following transurethral prostatectomy. Br J Urol 1995; 75: 12–3.
Bieri S, Iselin CE, Rohner S. Capsular perforation localization and adenoma size as prognosis indicator of erectile dysfunctional after transurethral prostatectomy. Scand J Urol Nephrol 1997; 31: 545–8.
Mi ZG, Yang XF, Liang XZ, Liu HY, Liu SY, Zhang H, et al. Adenoma of the posterior urethra: 131 case report. Asian J Androl 2001; 3: 67–70.
Taher A. Erectile dysfunction after transurethral resection of the prostate: incidence and risk factors. World J Urol 2004; 22: 457–60.
Perera ND, Hill JT. Erectile and ejaculatory failure after transurethral prostatectomy. Ceylon Med J 1998; 43: 74–7.
Zohar J, Meiraz D, Maoz B, Durst N. Factors influencing sexual activity after prostatectomy: a prospective study. J Urol 1976; 116: 332–4.
Brookes ST, Donovan JL, Peters TJ, Abrams P, Neal DE. Sexual dysfunction in men after treatment for lower urinary tract symptoms: evidence from randomised controlled trial. BMJ 2002; 324: 1059–61.