To evaluate the impact of photoselective vaporization of the prostate (PVP) on erectile function (EF) utilizing a 160W GreenLight laser system with up to 36 months of follow-up in men with lower urinary tract symptoms caused by benign prostatic hyperplasia.

A prospectively maintained database of patients who underwent GreenLight PVP was retrospectively reviewed. International Index of Erectile Function-5 (IIEF-5) questionnaire was used to assess EF. In total, 265 sexually active patients who underwent 160W GreenLight laser PVP were identified and divided into Group A with baseline IIEF-5 <19 and group B with baseline IIEF-5 ≥19. IIEF-5, International Prostate Symptom Score, quality of life, postvoid residual, and Qmax were recorded preoperatively, perioperatively, and at follow-up after 1, 3, 6, 12, 24, and 36 months. Recorded data were analyzed statistically using t- and χ² tests.

The preoperative and perioperative data of the 2 groups were comparable. Significant improvements in International Prostate Symptom Score, Qmax, quality of life, and postvoid residual were observed in both groups at every follow-up visit throughout the 36 months with no significant difference between the groups. EF was sustained postoperatively compared with the baseline in the whole study population. In Group A (preoperative IIEF-5 <19), EF was significantly improved at 1 month and 12 month (P= .02 and P= .002).

In patients undergoing PVP by 160W GreenLight laser for lower urinary tract symptoms secondary to benign prostatic hyperplasia, no significant detrimental effect was observed in the EF at up to 3 years of follow-up. However, in patients with preoperative erectile dysfunction (ED), we showed a significant improvement.