Effects of transurethral balloon dilation of the prostate on erectile and ejaculatory functions

Transurethral resection of the prostate, the traditional surgical treatment for benign prostatic hyperplasia (BPH), is associated with a 5-12% incidence of impotence postoperatively and almost always results in retrograde ejaculation. These complications are of major concern to many men, especially younger men. Transurethral balloon dilation of the prostate (TUDP) as a treatment for BPH is growing in popularity. However, questions on the long-term effectiveness of TUDP and its effects on ejaculatory and erectile function remain unanswered. Our study group consisted of 28 patients, 53-76 years old (average age 65) who underwent TUDP for treatment of BPH. The procedure was performed with the patient under local prostatic block anesthesia. The prostate and bladder neck were dilated to 90 French for 10 minutes using a double balloon catheter that had been introduced over a guide wire. The distal rhabdosphincter was located using digital transrectal palpation, endoscopy, or fluroscopy. The patients were asked to complete a questionnaire addressing erectile and ejaculatory function before and three months after TUDP. Information on erectile function was obtained from 26 patients. Of these, 20 reported no change in function after TUDP, 5 reported a subjectively improved quality of erection and 1 reported a subjectively decreased quality of erection. Information on ejaculatory function was obtained from 19 patients. Of these, 18 reported no change in function after TUDP and 1 reported a decrease in the quality of ejaculation. We conclude that TUDP does not have detrimental effects on erectile function but, in rare cases, could result in a decrease in the quality of ejaculation.