Objectives: The influence of surgical treatment of bladder outlet obstruction on sexual function is uncertain and available evidence is conflicting. Transurethral resection of the prostate (TURP) causes retrograde ejaculation, but its effect on erectile function is controversial. We have prospectively investigated the influence of TURP on erectile and ejaculatory function.
Methods: Between January 2000 and January 2005, 11 hospitals in Switzerland informed the Verein Outcome (VO), an independent institution specialising in outcome measurements in the Swiss health care system, about patients scheduled for TURP. VO obtained the Danish Prostate Symptom Score (DAN-PSS) including the sexual function domain (DAN-PSSsex) before and 4 mo after surgery and compared the respective scores.
Results: Data from 1014 patients were evaluated. Mean patient age was 69 yr. DAN-PSSsex questionnaires were returned by 988 patients before and 642 patients after TURP; 722 (73.1%) and 474 (73.8%) of the patients, respectively, stated that they were still sexually active. The mean erectile function score improved insignificantly from 1.66 to 1.47 (p=0.11), the mean ejaculatory function score worsened from 1.27 to 2.34 (p<0.00) and the mean discomfort on ejaculation score improved from 0.37 to 0.29 (p=0.10) before and after TURP, respectively.
Conclusion: The results confirm that TURP has no negative influence on the quality of erections measured by self-assessment questionnaires. The loss of ejaculatory function is significant and is associated with considerable bother. However, three of four patients undergoing TURP are still sexually active and the surgery has no influence on this ratio.