Comparing the effects on sexual function of prostatic urethral lift and medical therapy in men with benign prostatic hyperplasia.

This study aimed to compare the effects of prostatic urethral lift (PUL) and medical treatment on sexual function in men with benign prostatic hyperplasia (BPH). The main finding was that PUL was more effective at preserving sexual health in these men.

BPH is an enlarged prostate gland. BPH commonly causes lower urinary tract symptoms (LUTS). This may include overactive bladder, involuntary leakage of urine (incontinence), or discomfort passing urine. There are many medicines used to treat BPH. These include doxazosin (Cardura) and finasteride (Proscar). Side effects of these therapies may include sexual dysfunction.  

PUL is a minimally invasive surgical treatment for LUTS as a result of BPH. It involves separating the enlarged lobes of the prostate gland making the urethra (the tube that passes urine) wider to make urination easier. PUL may avoid the sexual dysfunction experienced with medical treatment for BPH. However, few studies compared the sexual function in men treated with medical therapy or PUL for BPH. 

This study analyzed the results of 4 clinical trials. Overall, 190 sexually active men in 3 trials had PUL and 849 sexually active men and had medical therapy for BPH. Medical therapy included doxazosin, finasteride, a combination of both, or a placebo. Urinary symptoms and changes in erectile function, ejaculation, and sexual satisfaction were compared at 12, 24, 36, and 48 months.

After 12 months, those in the PUL studies experienced a 17% improvement in erectile function. Similarly, after 24 months, there was a 21% improvement in erectile function after PUL. Doxazosin had no impact on erectile function at any stage in the study. However, at 48 months, finasteride reduced erectile function by 11%. At 12 months, combination medical treatment led to a 4% decrease in erectile function.

PUL was also more effective than the medications at improving ejaculation and sexual satisfaction over 48 months.

This study suggested that PUL was more effective than medical therapy at preserving sexual function in men with BPH.

This study compared the results of 4 different trials which were carried out by different investigators and had different protocols. Therefore, the results may not be truly comparable.

If you have questions about the treatment of BPH, please consult your doctor.