By David Douglas
NEW YORK (Reuters Health) May 27 - In men with benign prostatic hyperplasia, photoselective vaporization of the prostate can lead to a significant decrease in erectile function, French researchers report.
Overall, the patients in their cohort maintained their sexual function after the procedure - but not if they had normal function beforehand. In those men, photoselective vaporization had a major adverse effect on erectile function.
"Erectile dysfunction may be a real issue after photoselective vaporization of the prostate," said lead author Dr. Franck Bruyere in e-mail to Reuters Health. "In our study we showed a significant impact of laser reduction of the prostate in men with preoperative normal International Index of Erectile Function (IIEF-5) score."
As they reported online May 6th in European Urology, Dr. Bruyere and colleagues at the University Hospital of Tours followed 149 men with a median age of 74 years who underwent prostate vaporization with the GreenLight laser (American Medical Systems). Thirty-nine had normal preoperative erectile function as indicated by an IIEF-5 score of 19 or more.
All of the patients had significant improvements in urinary function after the surgery. And overall, other than a temporary difference at 1 year, IIEF-5 scores were comparable preoperatively and postoperatively.
By subgroup, however, there was a significant decrease in erectile function at 6, 12 and 24 months postoperatively in the men with normal preoperative scores. Their mean IIEF-5 score fell from 22.0 preoperatively to 16.7 at 2 years.
According to Dr. Bruyere, photoselective vaporization of the prostate is "still important" for men on anticoagulants or with comorbidities. "We don't plan to decrease our use of the GreenLight laser, but we'll counsel patients regarding our findings," he said.
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