What This Means
This research reviews the latest evidence on how newer treatments for benign prostatic hyperplasia (BPH), also known as an enlarged prostate, affect sexual health. BPH causes urinary problems like difficulty urinating, frequent urination, and weak urine flow, and treatments range from medications to various surgical procedures. A key concern with many of these treatments has historically been their negative impact on sexual function, particularly ejaculation problems.
The review found that several newer minimally invasive procedures — including Optilume, Rezum, Urolift, iTind, and prostatic artery embolization — appear to carry minimal risk of causing sexual dysfunction. However, these procedures also tend to be less effective at relieving urinary symptoms compared to the traditional standard surgical treatment, transurethral resection of the prostate (TURP). One newer procedure called Aquablation stands out as an exception: it appears to relieve urinary symptoms about as well as TURP, while causing significantly less ejaculatory dysfunction. This suggests it may offer the best of both worlds for some patients.
This research suggests that men being treated for BPH should have detailed conversations with their doctors about how different treatment options may affect their sexual function, since both medications and surgeries carry some degree of risk. The authors also highlight that more research is needed, particularly studies comparing these newer procedures directly against each other rather than only against TURP, and studies that track patients over longer periods of time to see how well these treatments hold up.