Objective: To evaluate the impact of 120 W GreenLight High Performancer System photoselective vaporization of the prostate (HPS-PVP) on erectile function at long-term follow-up in men with LUTS due to benign prostatic hyperplasia (BPH).
Methods: Three hundred and fifty-one consecutive patients who underwent HPS-PVP during 2008-2012 were analyzed retrospectively. We divided all patients into three groups: group I [International Index of Erectile Function (IIEF-5) ≤7, n=202], group II (8≤ IIEF-5 ≤16, n=90) and group III (IIEF-5 ≥17, n=59) according to the preoperative IIEF-5. The patients were assessed before surgery and at 3, 12 and 24 months after HPS-PVP. We measured IPSS, QoL, Qmax, post void residual volume and IIEF-5 at each visit. The risk factors were evaluated for over three IIEF-5 points decrease at postoperative 3 months.
Results: The mean age, presence of hypertension, prostate volume, IPSS and QoL were significantly different among three groups. Perioperative parameters such as operative time, applied energy, catheterization time and postoperative complication rates showed no statistical differences. In all groups, main parameters following operation such as IPSS, QoL, Qmax, and post void residual volume had significant improved compared to baseline. Whereas, the IIEF-5 was significant decrease in group II and group III. On the contrary, group I was increased. In group II and III, multivariate analysis showed that the age, BMI, and prostate volume were significantly related to a diminution of erectile function after HPS-PVP.
Conclusions: Sexual function was significantly deceased after HPS-PVP except patients with preoperative severe erectile dysfunction (IIEF-5 ≤7). The age, BMI, and prostate volume were the independent risk factors for erectile function decline after HPS-PVP.
