Research and Reports in Urology (Apr 2019)
The impact of prostate-transurethral resection on erectile dysfunction in benign prostatic hyperplasia
Abstract
Anak Agung Gde Oka,1 Gede Wirya Kusuma Duarsa,1 Putu Astri Novianti,2 Tjokorda Gde Bagus Mahadewa,2 Christopher Ryalino31Departments of Urology, Faculty of Medicine, Udayana University, Denpasar, Indonesia; 2Surgery, Faculty of Medicine, Udayana University, Denpasar, Indonesia; 3Anesthesiology, Faculty of Medicine, Udayana University, Denpasar, IndonesiaBackground: Erectile dysfunction (ED) after a prostate-transurethral resection (P-TUR) is one of the problems in the treatment of benign prostatic hyperplasia (BPH) that may affect the quality of life in middle-aged and older men. The aim of this study was to investigate the impact of P-TUR on ED in BPH patients.Methods: This study was conducted on 83 patients suffering from BPH that underwent a P-TUR. Clinically, testosterone levels, prostatic-specific antigen (PSA) levels, and prostate volume were measured before the P-TUR. Erectile function was measured prior to the P-TUR, as well as at 1 and 3 months after the P-TUR using the International Index of Erectile Function (IIEF). Suitability test of the model was done in a structural equation. Data were analyzed using the chi-square (χ2,) test by Analysis of Moment Structure (AMOS) software version 21.Results: The effects of PSA to IIEF before, 1 month after, and 3 months after P-TUR were 0.116, 0.084, and 0.097, respectively. The effects of body mass index to IIEF before, 1 month after, and 3 months after P-TUR were 0.180, 0.066, and 0.164, respectively. The effects of prostate volume to IIEF before, 1 month after, and 3 months after P-TUR were 0.049, 0.004, and 0.011, respectively. The effects of testosterone to IIEF before, 1 month after, and 3 months after P-TUR were –0.029, –0.453, and –0.415, respectively. The effects of age to IIEF before, 1 month after, and 3 months after P-TUR were –0.444, 0.921, and 0.911, respectively.Conclusion: There was a significant improvement of erectile function in patients that underwent P-TUR who previously had preoperative ED, especially 3 months after the surgery.Keywords: age, prostate volume, testosterone, PSA, IIEF, improvement