Photoselective Laser Vaporization of the Prostate in Benign Prostatic Obstruction: Sexual Function in Focus


  • Ihor Gorpynchenko State Institution «Institute of Urology of NAMS of Ukraine»
  • Andrii Sytenko State Institution «Institute of Urology of NAMS of Ukraine»
  • Oksana Vintoniv Ivano-Frankivsk National Medical University



sexual function, erection, ejaculation, photoselective laser vaporization of the prostate, green laser


The objective: to determine the effect of photoselective laser vaporization (FVP) on individual IIEF domains (sexual activity, libido, erection, ejaculation, ograzm, satisfaction with intercourse) in sexually active men with BPO, as well as the factors on which this effect depends.

Materials and methods. 95 sexually active patients with benign prostatic obstruction (BPO) (prostate volume >40 cm3, maximum urinary flow rate Qmax <10 ml/s; QoL≥4) at the age of 45 to 60 years underwent FP (GreenLight XPS, MoxyFiber) ... Sexual function (IIEF), urination parameters (PSS/QoL, PVR, Qmax), prostate volume, intravesical prostate protrusion, PSA were assessed before the intervention and 3 months after.

Results. PVP had a statistically significant and clinically significant effect on micturition parameters characterizing obstruction, prostate size and QoL. The median IPSSobstructive decreased by 6 (4–7) points (W=7.6; P<0.01), PVR by 48 (38–60) ml (W=6.2; P<0.01), IPP by 0.9 (0.5–1.5) cm (W=9.4; P<0.01) Vprostate at 31 (22–42) cm3 (W=8.5; P<0.01), QoL by 3 (2–4) points (W=11.2; P<0.01). The median Qmax increased by 23 (15–29) ml/s (W=13.3; P<0.01). The median values of the IPSSirritative and IPSSnocturia domains did not change significantly (P<0.8 and P<0.6, respectively). At 3 months after PVP, 84 (94.6 %) patients restored sexual activity. In 33 (39.28 %) of them, an improvement in erection and 15 (17.85 %) deterioration were found. 61 (72.26 %) lost emission.

Conclusions. The most significant effect of PVP on ejaculatory function is the loss of emission. The effect of PVP on erection is multidirectional and manifests itself in its improvement and deterioration. Further research is needed to determine the mechanisms by which PVP affects erection and ejaculation in order to prevent negative effects.

Author Biographies

Ihor Gorpynchenko, State Institution «Institute of Urology of NAMS of Ukraine»

Ihor I. Gorpynchenko,

Head of Department of Sexopathology and Andrology

Andrii Sytenko, State Institution «Institute of Urology of NAMS of Ukraine»

Andrii M. Sytenko,

Department of Sexopathology and Andrology

Oksana Vintoniv, Ivano-Frankivsk National Medical University

Oksana R. Vintoniv,

Department of Urology


Abrams, P., et al. The standardization of terminology of lower urinary tract function: report from the Standardization Subcommittee of the International Continence Society // Neurourol Urodyn, 2002.21:167.

Kok Bin Lim Epidemiology of clinical benign prostatic hyperplasia //Asian J Urol. 2017 Jul; 4(3):148–151.

Patel R.M. Bariol S. National trends in surgical therapy for benign prostatic hyperplasia in Australia //ANZ. J.Surg. 2019 Apr;89(4):345–349.

Malaeb B.S., Yu X., McBean A.M., Elliott S.P. National Trends in Surgical Therapy for Benign Prostatic hyperplasia in the United States (2000-2008) // Urology.2012;79(5):1111–1116.

Nora G Lee, Hui Xue, Lori B Lerner Trends and attitudes in surgical management of benign prostatic hyperplasia // Can. J. Urol. 2012;19(2):6170–5.

Terrasa J.B., Cornu J.N., Haab F., Cussenot O., Lukacs B. Prospective, multidimensional evaluation of sexual disorders in men after laser photovaporization of the prostate // J. Sex. Med. 2013 May;10(5):1363–71.

Spaliviero M., Strom K.H., Gu X., Araki M., Culkin D.J., Wong C. Does Greenlight HPS(™) laser photoselective vaporization prostatectomy affect sexual function? // J. Endourol. 2010;24(12):2051–7.

Kavoussi P.K., Hermans M.R. Maintenance of erectile function after photoselective vaporization of the prostate for obstructive benign prostatic hyperplasia // J. Sex. Med. 2008;5(11):2669–71.

Ghobrial F.K., Shoma A., Elshal A.M., Laymon M., El-Tabey N., Nabeeh A., Shokeir A.A. A randomized trial comparing bipolar transurethral vaporization of the prostate with GreenLight laser (xps-180watt) photoselective vaporization of the prostate for treatment of small to moderate benign prostatic obstruction: outcomes after 2 years // BJU Int 2020;125:144–152.

Elshal A.M., Elmansy H.M., Elkoushy M.A., Elhilali M.M. Male sexual function outcome after three laser prostate surgical techniques: a single center perspective // Urology. 2012;80(5):1098–104.

Hossack T.A., Woo H.H. Sexual function outcome following photoselective vaporisation of the prostate // Int Urol Nephrol. 2012;44(2):359–64.

Li Z., Chen P., Wang J., Mao Q., Xiang H., Wang X., Wang X., Zhang X. The impact of surgical treatments for lower urinary tract symptoms/benign prostatic hyperplasia on male erectile function. A systematic review and network metaanalysis

Fwu C.W., Eggers P.W., Kirkali Z., McVary K.T., Burrows P.K., Kusek J.W. Change in sexual function in men with lower urinary tract symptoms/benign prostatic hyperplasia associated with long-term treatment with doxazosin, finasteride and combined therapy // J Urol. 2014 Jun;191(6):1828–34. doi: 10.1016/j.juro.2013.12.014. Epub 2013 Dec 14.

Kiguradze T., Temps W.H., Yarnold P.R, Cashy J, Brannigan RE, Nardone B, Micali G, West DP, Belknap SM. Persistent erectile dysfunction in men exposed to the 5α-reductase inhibitors, finasteride, or dutasteride.

Purkait B, Sinha RJ, Srinivas KSA, Bansal A, Sokhal AK, Singh V. Outcome analysis of transurethral resection versus potassium titanyl phosphate-photo selective vaporization of the prostate for the treatment of benign prostatic hyperplasia; a randomized controlled trial with 4 years follow up // Turk J Urol. 2017 Jun;43(2):176–182.

Wang X, Liu M, Zhang YG, Zhu SC, Wan B, Wang JY. Photoselective paporesection of the prostate with an end-firing lithium triborate crystal laser // Chin Med J 2017;130:636–41.

Guo Z., Jin X. The volume of prostate can impact the male sexual function following photoselective vaporization of the prostate: results of a prospective analysis of 128 patients with 2-year follow-up. // Int Urol Nephrol. 2013 Aug;45(4):961–6.

Elshal A.M., Elmansy H.M., Elkoushy M.A., Elhilali M.M. Male sexual function outcome after three laser prostate surgical techniques: a single center perspective // Urology. 2012 Nov;80(5):1098–104.

Bouchier-Hayes D.M., Van Appledorn S, Bugeja P, Crowe H, Challacombe B, Costello AJ. A randomized trial of photoselective vaporization of the prostate using the 80-W potassium-titanyl-phosphate laser vs transurethral prostatectomy, with a 1-year follow-up // BJU Int. 2010 Apr;105(7):964–9.

Bruyère F., Puichaud A., Pereira H., d’Arcier B.F., Rouanet A., Floc’h A.P., Bodin T., Brichart N. Influence of photoselective vaporization of the prostate on sexual function: results of a prospective analysis of 149 patients with long-term follow-up // European Urology 2010;Vol 58, Issue 2, P. 207–211.

Guo S, Müller G, Lehmann K, Talimi S, Bonkat G, Püschel H, Gasser T, Bachmann A, Rieken M. The 80-W KTP GreenLight laser vaporization of the prostate versus transurethral resection of the prostate (TURP): adjusted analysis of 5-year results of a prospective non-randomized bi-center study. // Lasers Med Sci. 2015 Apr;30(3):1147–51.

Anderson BB, Pariser JJ, Helfand BT. Comparison of Patients Undergoing PVP Versus TURP for LUTS/BPH // Curr Urol Rep. 2015 Aug;16(8):55–525

Mohanty N.; Kumar A.; Vasudeva P.; Arora R. Photoselective vaporization of prostate vs. transurethral resection of prostate: A prospective, randomized study with one year follow-up // Indian J Urol. 2012 Jul-Sep;28(3):307–312.

E.A. Lytvynets, A.I. Sytenko, O.R. Vintoniv, D.B. Solomchak, H.R. Stoliarchuk Influence of photoselective vaporization of prostatic gland on sexual function in men with adenoma of prostate // Urologia 2019; Vol 23, 1, P.13–16.

A. Sytenko, I. Gorpynchenko, O. Vintoniv Photoselective laser vaporization of the prostate: pronounced negative effect on the ejaculatory function // Sexual Medicine Vol. 15, Issue 7, Suppl 3, S381, JULY 01, 2018.






Sexology and andrology