Role of risk factors for erectile dysfunction in patients undergoing transurethral resection of the prostate: early impact on sexual function.

INTRODUCTION: Transurethral resection of the prostate (TURP) has been long debated as a possible cause of erectile dysfunction (ED). We investigated the role of common risk factors for ED in patients aged 60 to 70 undergoing TURP Factors related to the treatment were also considered. MATERIALS AND METHODS: Ninety patients underwent TURP for benign prostate hyperplasia (BPH) from June 2002 to February 2003. Fourty-two of them, sexually active aged 60 to 70, were administered preoperatively and 3-month postoperatively the International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF-5) questionnaires. A complete assessment of risk factors for ED was performed in the preoperative setting (treated hypertension, diabetes, cigarette smoking, hypercolesterolemy, cardiovascular disease). IIEF score was related to age, comorbidities, operative time, resected tissue weight, retrograde ejaculation, IPSS score. RESULTS: Nine (21.4%) patients reported worsened IIEF-5 score after TURP, and 33 (78.6%) unchanged/improved score. Cardiovascular disease was present in 56% of patients with worsened IIEF-5 score and in 12% of patients with improved/unchanged IIEF-5 score; it was the only factor that correlated significantly in the regression model. CONCLUSION: In general, most patients report a stable sexual function after TURP. Patients with known cardiovascular disease undergoing TURP had an increased risk of sexual impairment after this procedure.