The impact of minimally invasive surgical therapy for Benign prostatic hyperplasia on sexual function: a systematic review and meta-analysis.

IF 5.8 2区医学 Q1 ONCOLOGY

Prostate Cancer and Prostatic Diseases Pub Date : 2026-03-03 DOI:10.1038/s41391-026-01091-x

Ellen M Cahill, Marcelo Mass Lindenbaum, Alexander Estright, Bernardita M Ljubetic, Vivek Aslot, Neil Nero, Smita De, Petar Bajic, Raevti Bole

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引用次数: 0

Abstract

Introduction: Benign prostatic hyperplasia (BPH) and associated lower urinary tract symptoms (LUTS) can significantly impair a man's quality of life. While traditional surgical treatments are effective, they often pose risks to sexual function, particularly in the form of ejaculatory and/or erectile dysfunction. Minimally invasive surgical treatments (MISTs) have emerged as alternative procedures that aim to alleviate LUTS while preserving sexual function.

Objective: Investigate the impact of MISTs for BPH on sexual function including erectile and ejaculatory function.

Methods: In May 2025, a systematic review and meta-analysis of sexual function outcomes in MISTs was performed using the Ovid, Embase, and Medline/PubMed databases. Articles were included if they were in English, assessed a MIST, and incorporated sexual function outcomes. Articles were excluded if they included pooled analyses, were abstracts without full text, and/or were ongoing incomplete clinical trials. We included studies on water vapor thermal therapy (Rezum), prostatic urethral lift (Urolift), prostatic artery embolization (PAE), temporary implantable nitinol device (iTIND), Optilume BPH catheter system, and transperineal laser ablation (TPLA). Outcomes included erectile function using International Index of Erectile Function (IIEF) scores and ejaculatory function using the Male Sexual Health Questionnaire (MSHQ).

Results: The initial search yielded 2646 studies. After screening and full text review, 77 studies met inclusion criteria encompassing a total of 11,477 patients. Based on the pooled analyses, IIEF scores significantly improved after Rezum and Urolift. Urolift significantly improved MSHQ-function and bother scores, while Rezum only improved MSHQ-bother scores. PAE, iTind, Optilume, and TPLA did not significantly impact erectile or ejaculatory function.

Conclusions: MISTs are a promising option for management of BPH in patients interested in maintaining sexual function, preserving or even improving erectile and ejaculatory function.

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微创手术治疗良性前列腺增生对性功能的影响：系统回顾和荟萃分析。

简介：良性前列腺增生（BPH）和相关的下尿路症状（LUTS）可以显著损害男性的生活质量。虽然传统的手术治疗是有效的，但它们往往会对性功能造成风险，尤其是射精和/或勃起功能障碍。微创手术治疗（mist）已成为旨在减轻LUTS同时保留性功能的替代程序。目的：探讨治疗前列腺增生症的MISTs对性功能包括勃起和射精功能的影响。方法：2025年5月，使用Ovid、Embase和Medline/PubMed数据库对mist患者的性功能结局进行了系统回顾和荟萃分析。纳入英文文章，评估MIST，并纳入性功能结果。如果文章包含汇总分析，没有全文的摘要，和/或正在进行的不完整临床试验，则排除。我们纳入了水蒸气热疗法（Rezum）、前列腺尿道提升术（Urolift）、前列腺动脉栓塞术（PAE）、临时植入式镍钛诺装置（iTIND）、Optilume BPH导管系统和经会阴激光消融（TPLA）的研究。结果包括使用国际勃起功能指数（IIEF）评分的勃起功能和使用男性性健康问卷（MSHQ）的射精功能。结果：最初的搜索产生了2646项研究。经过筛选和全文审查，77项研究符合纳入标准，共纳入11477名患者。基于汇总分析，Rezum和Urolift治疗后IIEF评分显著提高。Urolift显著提高了MSHQ-function和bother评分，而Rezum仅提高了MSHQ-bother评分。PAE, iTind， Optilume和TPLA对勃起或射精功能没有显著影响。结论：对于希望维持性功能、保留甚至改善勃起和射精功能的患者，mist是一种很有希望的治疗BPH的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Prostate Cancer and Prostatic Diseases 医学-泌尿学与肾脏学

CiteScore

10.00

自引率

6.20%

发文量

142

审稿时长

6-12 weeks

期刊介绍： Prostate Cancer and Prostatic Diseases covers all aspects of prostatic diseases, in particular prostate cancer, the subject of intensive basic and clinical research world-wide. The journal also reports on exciting new developments being made in diagnosis, surgery, radiotherapy, drug discovery and medical management. Prostate Cancer and Prostatic Diseases is of interest to surgeons, oncologists and clinicians treating patients and to those involved in research into diseases of the prostate. The journal covers the three main areas - prostate cancer, male LUTS and prostatitis. Prostate Cancer and Prostatic Diseases publishes original research articles, reviews, topical comment and critical appraisals of scientific meetings and the latest books. The journal also contains a calendar of forthcoming scientific meetings. The Editors and a distinguished Editorial Board ensure that submitted articles receive fast and efficient attention and are refereed to the highest possible scientific standard. A fast track system is available for topical articles of particular significance.