The Effects of Interstitial Laser Coagulation on Quality of Life and Sexual Function in Patients with Benign Prostatic Hyperplasia

Jo, Seok Su; Choi, Seong; Rhew, Hyun Yul

Abstract

PURPOSE: To determine the impact of interstitial laser coagulation (ILC) on the quality of life and sexual function in patients with a benign prostatic hyperplasia (BPH).
MATERIALS AND METHODS
Eighty-nine patients treated with ILC were prospectively evaluated. The treatment outcome was evaluated 1, 3, 6 months and 1 year after the ILC with the international prostate symptom score (IPSS), the prostate volume, the peak urinary flow rate (Q-max), the post-void residual urine (PVR), and the quality of life assessment score. In addition, a self-reporting questionnaire including the International Index of Erectile Function (IIEF) were completed before and 3 months after treatment to determine the impact on sexual function.
RESULTS
ILC showed significant improvement in the clinical and voiding parameters (IPSS, Q-max, PVR, prostate size). After ILC, 76% of patients were satisfied with the treatment and the quality of life score improved significantly after 3 months. There was no significant difference between the mean scores of the pretreatment and post-treatment erectile function, orgasmic function, sexual desire and intercourse satisfaction. However, the overall satisfaction score decreased from the pre-operative value of 3.05 to a post-operative value of 2.27 (p<0.05). An ejaculation loss or severe decrease in ejaculate volume was reported in 11 (23%) of the 46 patients followed up after ILC. Interestingly, only 5 (45%) of the 11 patients with a loss of ejaculation or severe decrease in ejaculate reported a deterioration of their sex life, while only 1 (4%) of the 23 without any change in ejaculate volume reported such deterioration.
CONCLUSIONS
There were no significant changes in sexual desire, erectile function, orgasmic function, and intercourse satisfaction with ILC. However, the overall satisfaction decreased after ILC. Post-treatment sexual dysfunction appears to be mainly related to the impaired ejaculatory function.