Opinion
Video
BPH Treatment and Impact on Sexual Health
Author(s):
Panelist discusses how benign prostatic hyperplasia (BPH) and its treatments impact men’s sexual health, emphasizing the importance of balancing symptom relief with sexual function preservation, and how patient concerns, along with treatment advancements like aqua ablation, have simplified decision-making in clinical practice.
Video content above is prompted by the following:
Impact of BPH and Its Treatments on Men’s Sexual Health
Patient concerns:
Men with BPH often express significant anxiety about losing sexual function and experiencing incontinence posttreatment. However, many lack a clear understanding of how different treatments impact aspects such as erections, ejaculation, and orgasm quality.
Counseling approach:
Physicians should provide precise, transparent discussions about the sexual adverse effects of BPH treatments. Terms like “dry orgasm” and “retrograde ejaculation” should be explicitly explained, as patients may not realize how these changes affect their overall sexual experience.
Treatment considerations:
- Traditional procedures such as HoLEP (Holmium Laser Enucleation of the Prostate) and robotic simple prostatectomy provide excellent symptom relief but commonly result in retrograde ejaculation, which can alter orgasm sensation.
- Some patients underestimate the impact of these changes, often assuming a “dry orgasm” is merely a logistical difference rather than a fundamentally altered experience.
- Aqua ablation has emerged as a preferred option due to its balance of symptom relief, durability, and sexual function preservation.
Evolving BPH treatment algorithm:
Historically, BPH treatment selection was complex, with different approaches for small, medium, and large prostates. Aqua ablation, described as a “Swiss army knife” for BPH, has simplified the algorithm, offering effective treatment across various prostate sizes and anatomical variations.
Physician responsibility:
Ensuring patients are fully informed about both the benefits and trade-offs of BPH treatments is crucial. Many patients may not receive comprehensive counseling on the sexual adverse effects of traditional procedures. A patient-centric approach that prioritizes both symptom relief and sexual function preservation is essential in guiding treatment decisions.
