Impact of Surgery for Benign Prostatic Hyperplasia on Sexual Function: A Systematic Review and Meta-analysis of Erectile Function and Ejaculatory Function

Manfredi, Celeste; García‐Gómez, Borja; Arcaniolo, Davide; García‐Rojo, Esther; Crocerossa, Fabio; Autorino, Riccardo; Gratzke, Christian; Sio, Marco De; Romero-Otero, Javier

doi:10.1016/j.euf.2022.06.007

Cited by 16 publications

(9 citation statements)

References 173 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A previous meta-analysis investigating PAE further reported that 99% of complications were reported as minor out of a 33% overall complication rate [ 30 ]. In addition, postoperative sexual dysfunction is more commonly reported in TURP patients, which has been associated with erectile nerve damage and heating from the electrode used [ 31 ]. Lower sexual dysfunction rates after PAE is an important finding as these complications significantly impact patients’ QOL and well-being.…”

Section: Discussionmentioning

confidence: 99%

Comparing prostatic artery embolization to surgical and minimally invasive procedures for the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis

Altman,

Ferreira,

Barragan

et al. 2024

BMC Urol

View full text Add to dashboard Cite

Background To summarize current evidence to report a comparative systematic review and meta-analysis of prostatic artery embolization (PAE) with transurethral resection of the prostate (TURP) and open simple prostatectomy (OSP) for the treatment of benign prostatic hyperplasia (BPH). Methods A systematic literature search was performed to identify studies published from inception until August 2021. The search terms used were (prostate embolization OR prostatic embolization) AND (prostatic hyperplasia OR prostatic obstruction) as well as the abbreviations of PAE and BPH. Risk of bias was assessed using the Cochrane Risk of Bias tool for randomized controlled trials (RCTs) and the Risk of Bias in Non-randomized Studies—of Interventions (ROBINS-I) tool for observational studies. Random-effects meta-analysis was performed using Revman 5.4. Results Seven studies were included with 810 patients: five RCTs and one observational study compared PAE with TURP, and one observational study compared PAE with OSP. The included studies had considerable risk of bias concerns. TURP and OSP were associated with more statistically significant improvements in urodynamic measures and BPH symptoms compared to PAE. However, PAE seems to significantly improve erectile dysfunction compared to OSP and improve other outcome measures compared to TURP, although not significantly. PAE appeared to reduce adverse events and report more minor complications compared with TURP and OSP, but it is unclear whether PAE is more effective in the long-term. Conclusion PAE is an emerging treatment option for patients with symptomatic BPH who cannot undergo surgery or have undergone failed medical therapy. Overall, PAE groups reported fewer adverse events. Future ongoing and longer-term studies are needed to provide better insight into the benefit of PAE compared to other treatment options.

show abstract

Section: Discussionmentioning

confidence: 99%

Comparing prostatic artery embolization to surgical and minimally invasive procedures for the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis

Altman,

Ferreira,

Barragan

et al. 2024

BMC Urol

View full text Add to dashboard Cite

show abstract

“…Finally, erectile function is not affected by any minimally invasive surgical procedure. 56 Another review focused on PUL, PAE, aquablation, and WVTT confirms that all of them are effective in maintaining erectile and sexual function. 57 …”

Section: Evidence Synthesis and Guideline Recommendationsmentioning

confidence: 94%

“…All the MISTs analyzed in the present review are considered to offer a high chance of preserving ejaculatory function. 55 The most comprehensive literature review and meta-analysis, conducted by Manfredi et al , 56 shows that overall, MISTs are associated with a significantly lower risk ( P < 0.00001) of retrograde ejaculation than TURP and laser procedures. In particular, retrograde ejaculation shows no statistically significant increase for PAE and PUL, while there is a difference for aquablation.…”

Section: Evidence Synthesis and Guideline Recommendationsmentioning

confidence: 99%

Minimally invasive surgical therapies (MISTs) for lower urinary tract symptoms (LUTS): promise or panacea?

Busetto,

Checchia,

Recchia

et al. 2023

Asian Journal of Andrology

View full text Add to dashboard Cite

The increasing importance of treatment of lower urinary tract symptoms (LUTS), while avoiding side effects and maintaining sexual function, has allowed for the development of minimally invasive surgical therapies (MISTs). Recently, the European Association of Urology guidelines reported a paradigm shift from the management of benign prostatic hyperplasia (BPH) to the management of nonneurogenic male LUTS. The aim of the present review was to evaluate the efficacy and safety of the most commonly used MISTs: ablative techniques such as aquablation, prostatic artery embolization, water vapor energy, and transperineal prostate laser ablation, and nonablative techniques such as prostatic urethral lift and temporarily implanted nitinol device (iTIND). MISTs are becoming a new promise, even if clinical trials with longer follow-up are still lacking. Most of them are still under investigation and, to date, only a few options have been given as a recommendation for use. They cannot be considered as standard of care and are not suitable for all patients. Advantages and disadvantages should be underlined, without forgetting our objective: treatment of LUTS and re-treatment avoidance.

show abstract

“…ED [14][15][16][17][18][19][20], PE [21], PD [22][23][24][25][26][27][28][29][30], male infertility [31,32], genital aesthetic concerns [33][34][35][36][37], as well as several other conditions [38][39][40][41][42][43][44][45] can significantly impact the sexual health of male patients. When this happens, worries and doubts often lead patients to independently search for information on the Internet with every available tool [1,2].…”

Section: Our Findings and Available Literaturementioning

confidence: 99%

Voice Assistants as Consultants for Male Patients with Sexual Dysfunction: A Reliable Option?

Napolitano

Barone

Spirito

et al. 2023

IJERPH

Self Cite

View full text Add to dashboard Cite

The aim of this study was to evaluate the ability of Google Assistant, Alexa, and Siri to recognize and answer questions about male sexual health. Each VA was tested on a smart speaker: Alexa on Amazon Echo Dot 4th Gen., Google Assistant on Google Home Mini, and Siri on Apple HomePod. A pool of patients’ frequently asked questions regarding erectile dysfunction (ED), premature ejaculation (PE), Peyronie’s disease (PD), male infertility, and other aspects of male sexual health were identified by authors. The recognition of question was evaluated (“yes” or “not”). For each recognized question, the response characteristics (domains) were rated on a scale from 0 to 10 (according to the quality). We chose the recognition rate of the questions as the primary outcome and the quality of the answers as the secondary outcome. Overall, the best VA in recognizing questions was Siri, with a total of 83.3% questions compared with 64.0% for Alexa (p = 0.024) and 74.0% for Google Assistant (p = 0.061). Siri was associated with a significantly higher recognition rate than Alexa for PE (80% vs. 40%; p = 0.002) and PD (66.7% vs. 33.3%; p = 0.010). The quality of the responses was classified as low in 57 out of 105 cases (54.3%), intermediate in 46 cases (43.8%), and high in only 2 cases (1.9%), highlighting an overall intermediate-low quality of the answers. Male infertility was the condition associated with the highest mean scores in “Targeted response to the problem” (7.32 ± 2.57), “Scientific correctness of the answer”, (5.9 ± 2.76) “Completeness of the answer” (5.14 ± 2.56), and “Understandability of the response for a patient” (5.3 ± 2.51) domains. Siri was associated with significantly higher scores than Alexa (p < 0.05) in several domains of all conditions evaluated. The question recognition rate of VAs is quite high; however, the quality of the answers is still intermediate-low. Siri seems superior to Alexa in both question recognition and response quality. Male infertility appears to be the sexual dysfunction best addressed by VAs.

show abstract

Impact of Surgery for Benign Prostatic Hyperplasia on Sexual Function: A Systematic Review and Meta-analysis of Erectile Function and Ejaculatory Function

Cited by 16 publications

References 173 publications

Comparing prostatic artery embolization to surgical and minimally invasive procedures for the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis

Comparing prostatic artery embolization to surgical and minimally invasive procedures for the treatment of benign prostatic hyperplasia: a systematic review and meta-analysis

Minimally invasive surgical therapies (MISTs) for lower urinary tract symptoms (LUTS): promise or panacea?

Voice Assistants as Consultants for Male Patients with Sexual Dysfunction: A Reliable Option?

Contact Info

Product

Resources

About