Background: There is a link between Low Urinary Tract Symptoms (LUTS) and deterioration of sexual function in men >50 years of age and for which transurethral resection of the prostate (TURP) is considered the gold standard treatment despite the new minimally invasive surgical options.

Objectives: To evaluate the change in sexual function status after TURP in elderly Bangladeshi males.

Methods: One hundred patients presenting with BPH and treated with transurethral resection of prostate (TURP) in the Department of Urology, BSMMU, Dhaka from January2016 to December 2016over a period of one year were evaluated for postoperative sexual function.

Results: The mean age of the patients was 61.21±7.21 years while the mean duration of lower urinary tract symptoms was 24.3±6.40 months. Of the 91 patients with a living wife/partner, 44 (48.4%) had active sex lives preoperatively, 38(41.8T) of them had good erections whereas 6 (6.6%) had weak erections though they were able to have satisfactory penetration. All 44 (48.4%) had normal ejaculation prior to TURP. In the postoperative follow up, 10 (22.7%) of these 44 patients reported an improvement in their sex life in terms of increased libido and improved erections. Twenty-one (47.7%) had no change in their status after TURP, but were satisfied with their sex life. The remaining 13 (29.5%) had deterioration in their status in terms of decreased libido and poor erections.

Conclusions: About 48.4% of patients with a living spouse/partner are sexually active at the time of undergoing TURP. TURF leads to a deterioration of sexual function in up to 29.5% of these patients. This includes both loss of libido and erections.

Keywords: TURP, Erection, Libido.

1. Rosen R, Altwein J, Boyle P, et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol 2003, 44: 637–49.
2. Morgia G, Cimino S, Favilla V, et al. Effects of Serenoa Repens, Selenium and Lycopene (Profluss (R)) on chronic inflammation associated with benign prostatic hyperplasia: results of “FLOG” (Flogosis and Profluss in Prostatic and Genital Disease), a multicentre Italian study. Int Braz J Urol 2013, 39: 214–21.
3. van Dijk M, Skrekas T, de la Rosette JJ. The association between lower urinary tract symptoms and sexual dysfunction: fact or fiction? Cur rOpinUrol 2005, 15: 39–44.
4. Brookes ST, Donovan JL, Peters TJ, et al. Sexual dysfunction in men after treatment for lower urinary tract symptoms: evidence from randomised controlled trial. BMJ 2002, 324: 1059–61.
5. Rassweiler J, Teber D, Kuntz R, Hofmann R. Complications of transurethral resection of the prostate (TURP) — incidence, management, and prevention. Eur Urol 2006, 50: 969–79 (Discussion 80).
6. Kassabian VS. Sexual function in patients treated for benign prostatic hyperplasia. Lancet 2003, 361: 60–2.
7. Vale J. Benign prostatic hyperplasia and erectile dysfunction — is there a link? Curr Med Res Opin 2000, 16(Suppl 1): s63–7.
8. Jaidane M, Arfa NB, Hmida W, et al. Effect of transurethral resection of the prostate on erectile function: a prospective comparative study. Int J Impot Res 2010, 22: 146–51.
9. Choi SB, Zhao C, Park JK. The effect of transurethral resection of the prostate on erectile function in patients with benign prostatic hyperplasia. Korean J Urol 2010, 51: 557–60.
10. Braun M, Wassmer G, Klotz T, Reifenrath B, Mathers M. Engelmann U. Epidemiology of erectile dysfunction: results of the `Cologne finale survey'. Int J Impot Res 2000; 12(6): 305-11.
11. Avis NE. Sexual function and aging in men and women: community and population-based studies. J GendSpecif Med 2000; 3(2): 37-41.
12. Blanker MH, Bosch JL, Groeneveld FP, Bohnen AM, Prins A, Thomas S, Hop WC. Erectile and ejaculatory dysfunction in a community-based sample of men 50 to 78 years old: prevalence, concern and relation to sexual activity. Urology 2001; 57(4): 763-8.
13. Weidner W, Altwein J. Hauck E, Beutel M, Brahler E: Sexuality in the elderly: Urol Int 2001; 66: 181-4.
14. Marumo K, Nakashima J, Murai M. Age-related prevalence of erectile dysfunction in Japan: assessment by the International Index of Erectile Function. Int J Urol 2001; 8(2): 53-9.
15. Hernandez Millan I. Salinas Sanchez A, Romero JL, Segura Martin M, Virseda Rodriguez J. Sexual activity and surgery of benign prostatic hyperplasia. Arch EspUrol 2001; 54(1): 53-60.
16. Mishriki FS, Cohen NP, Mawas A, Gibbons B. TURP can improve your sex life. Abstract no. 1501, AUA 2001.
17. Arai Y, Aoki Y. Okubo K, Maeda H, Terada N, Matsuta Y et al. Impact of interventional therapy for benign prostatic hyperplasia on quality of life and sexual function. A prospective study. J Urol 2000; 164: 1206-11.
18. Holtgrewe HL, Valk WL. Late results of transurethral prostatectomy. J Urol 1964; 92: 51-5.
19. Finkle AL, Prian DV. Sexual potency in elderly men before and after prostate-ctomy. JAMA 1966; 196: 139-43.
20. Zlotta AR, Schulman C. BPH and sexuality. Eur Urol 1999; 36: 107-12.
21. Hargreave TB, Stephenson TP. Potency and prostatectomy. Br J Urol 1977; 49(7): 683-8.

Hossain F

Assistant Professor, Department of Urology, BSMMU, Dhaka