Erectile Dysfunction (ED) After Transurethral Resection of the

Prostate (TURP)
Bambang Sasongko Noegroho

Hasan Sadikin General Hospital

Urology Department, University of Padjadjaran
Bandung, 2015

Benign prostatic hyperplasia (BPH) and sexual dysfunctions are disorders that
occur with high prevalence in aged men. Several studies have found a link between
Low Urinary Tract Symptoms (LUTS) due to BPH and deterioration of sexual
function in men over the age of 50 and for which transurethral resection of the
prostate (TURP) is considered the gold standard therapy. However, the impact of
TURP on sexual function still remain uncertain and contradictory, with a number of
patients who actually refers new episodes of ED following TURP. The underlying
pathophysiology of these issue remain unclear. Other studies found improvement on
ED after TURP.
Several studies showed that ED after TURP may be related to other issues,
rather than TURP itself. Ivan G et al found that age of patients (>65 years) represents
an independent risk factor of erectile dysfunction at 12 months follow-up after TURP.
Zhao QQ et al found that ED after TURP may be related to capsular perforation and
psychological aspect of the patients.
Generally, diagnostic evaluation and management of ED after TURP is similar
to ED due to other causes. Comprehensive history taking, questionnaire, physical
examination, and laboratory tests should be integral part of ED evaluation. Pre-
operative potency and other co- morbidities may influence ED after TURP.
Management includes first line therapy (counseling, phosphodiesterase-5 inhibitors,
or vacuum device), second line (intracavernous injection), and third line (penile
prothesis). Qi MJ and Yu H et al found that Tadalafil is an effective and safe therapy
for ED after TURP.
In conclusions, TURP is still gold standard therapy for Benign Prostatic
Enlargement. Relationship between TURP and ED after TURP remain unclear.
Studies suggests that ED after TURP may be related to age, psychological aspect, and
intraoperative capsular perforation, rather than URP itself. Phosphodiesterase-5
inhibitors is effective and safe therapy for ED after TURP.

References

1. EAU guidelines. Male sexual dysfunction. 2015

2. Pavone C et al. Sexual dysfunctions after transurethral resection of the prostate
(TURP): Evidence from a retrospective study on 264 patients. Archivio Italiano di
Urologia e Andrologia 2015; 87, 1.
3. Mishriki SF. TURP and sex: patient and partner prospective 12 years follow- up
study. BJU Int. 2012 Mar;109(5):745-50
4. Yu H1 , Wu H, Rao D. Analysis of the therapeutic effect of tadalafil on male ED
after transurethral resection of prostate. Int J Impot Res. 2012 Jul-Aug;24(4):147-9
5. Qi MJ1 , Cao ZG, Ja RP, Xu Z, Xu LW, Liu J, Su JH. Tadalafil for ED after
transurethral resection of the prostate: a report of 113 cases. Zhonghua Nan Ke
Xue. 2011 Oct;17(10):894-6.