Prostatic Artery Embolization Allows to Maintain Full Sexual Activity in Patients Suffering from Bothersome Lower Urinary Tracts Symptoms related to Benign Prostatic Hyperplasia

Cardiovasc Intervent Radiol. 2020 Aug;43(8):1202-1207. doi: 10.1007/s00270-020-02520-7. Epub 2020 Jun 3.

Abstract

Introduction: The effect of prostate artery embolization (PAE) on male sexual function is currently the subject of debate in the literature. The main purpose of this study was to define changes in all domains of sexual activity after PAE, using the international index of erectile function score (IIEF-15).

Methods: A single-center retrospective study was conducted on 129 patients (mean age of 65.5 ± 7 years), who underwent PAE from February 2014 to January 2017 for symptomatic benign prostatic hyperplasia (BPH). Fifty consecutive patients fulfilling the inclusion criteria were evaluated before and after PAE follow-up using the IIEF-15, IPSS, prostate volume (PV) and cardiovascular risk factor and BPH drugs. The IIEF-15 domains analyzed were: erectile function (EF) ejaculation and orgasm (Ej/O), sexual desire (SD), intercourse satisfaction (IS) and overall satisfaction (OS). A paired sample t test or Wilcoxon signed-rank test was used to compare IIEF-15 between baseline and follow-up.

Results: The study showed nonsignificant change in IIEF-15 total score (58.0 ± 13.8 SD; p = 0.71) and the five domains (EF 24.5 ± 7.0 SD, p = 0.82; EJ/O 8.2 ± 2.3 SD, p = 0.50; SD 7.2 ± 2.7 SD, p = 0.57; IS 10.3 ± 3.0 SD, p = 0.77; OS 8.2 ± 2.7 SD; p = 0.11) after PAE. We also found a significant improvement in IPSS score after PAE.

Conclusion: Based on the IIEF-15 questionnaire, PAE was showed to allow good urinary symptoms results and no deterioration in sexual function.

Keywords: International index of erectile function-15 (IIEF-15); International prostate symptom score (IPSS); Lower urinary tract symptoms (LUTS); Prostatic artery embolization (PAE); Sexual dysfunction; Symptomatic benign prostatic hyperplasia (BPH); Transurethral resection of the prostate (TURP).

MeSH terms

  • Aged
  • Aged, 80 and over
  • Embolization, Therapeutic / methods*
  • Erectile Dysfunction / prevention & control*
  • Humans
  • Lower Urinary Tract Symptoms / etiology*
  • Lower Urinary Tract Symptoms / therapy*
  • Male
  • Middle Aged
  • Prostate / blood supply
  • Prostatic Hyperplasia / complications*
  • Prostatic Hyperplasia / therapy*
  • Retrospective Studies
  • Sexual Behavior / physiology
  • Surveys and Questionnaires
  • Treatment Outcome