In the so-called benign prostatic hyperplasia (BPH), tissue of the prostate gland grows increasingly more into the area of the urethra. Due to the narrowing of the urethra, the strength of the urine stream decreases and sometimes urine remains in the bladder. The consequences are constant urge to urinate, weak flow, and uncomfortable dribbling.
However, men with benign prostatic hyperplasia and lower urinary tract complaints (LUTS) often do not only complain about problems with urination. More than half of those affected by sexual dysfunction additionally suffer from the loss of libido or impotence problems, whereby, the frequency of dysfunction increases with the severity of the symptoms.
Improvement in erectile dysfunction through treatment
"If a benign enlarged prostate obstructs the emptying of the bladder, the treatment should not be delayed for too long," says Dr. Stephan Neubauer, urologist at the West German Prostate Center. Because appropriate therapy not only alleviates the pain when urinating but often also improves the sexual function of men.
While the positive influence of a drug treatment with alpha-blockers at sexual dysfunction could clearly be demonstrated in several studies, the endoscopic enucleation of the prostate (TURP) has far constituted a risk factor for the development of erectile dysfunction. „After a 12-year follow-up study1 this must be clearly refuted looking at current results," says the Cologne urologist. On the contrary: in 15 percent of the previously affected men, the sexual function improved after TURP.
This is provided that the surgery proceeds without complications. Here it makes sense instead of the conventional laser enucleation to choose gentler non-evasive methods such as the Green Light laser or diode laser as the therapy of choice, says Dr. Neubauer. Because modern laser therapy has the advantage that side effects such as impotence and incontinence are largely excluded and bleeding can be avoided almost entirely.
However, the fact that only every fifth BPH patient with sexual dysfunction is looking for help from the treating physician remains a problem. Dr. Neubauer therefore calls for urologists to either address BPH patients regarding their sexual function or dysfunction with appropriate interview techniques or with the help of special questionnaires.
1 Mishikri SF et al. 2011. TURP and sex: Patient and partner prospective 12 years follow-up study. BJU Int doi:10.1111