Benign Prostatic Hyperplasia and Sexual Dysfunction: Review of the Impact of New Medical and Surgical Therapies on Sexual Health.

Objective: The aim of this review is to evaluate recent literature surrounding the impact of new medical and surgical therapies for benign prostatic hyperplasia (BPH) on sexual health and function.

Results: Recent randomized controlled trials evaluating patients treated with Optilume, Rezum, Urolift, iTind, and prostatic artery embolism reported minimal associated risks for the development of sexual dysfunction. However, these treatments provide inferior improvement in lower urinary tract symptoms (LUTS) when compared to transurethral resection of the prostate (TURP) and simple prostatectomy. Aquablation demonstrates similar improvement in LUTS while significantly minimizing ejaculatory dysfunction compared to TURP. Management of BPH must include patient counseling on the potential risks of sexual dysfunction associated with both medical and surgical therapies. Future research should be guided towards comparing minimally invasive surgical therapies to one another and collecting long-term data on the durability of these therapies on urinary and sexual function.