AUA 2017: How Long Should Patients Wait Before Resuming Sexual Activity After BPH Surgery?

Boston, MA ( Surgical therapy for benign prostatic hyperplasia (BPH) is amongst the most common urological procedures. While most patients are expected to resume sexual activity postoperatively, data pertaining to the required time of abstinence is lacking. A traditional 6 week period of abstinence from any kind of sexual activity is recommended after BPH surgeries in many centers.

Dr. Goldberg presented a prospective questionnaire-based study enrolling sexually active men referred for either open/endoscopic BPH surgery. Patients were asked to complete an IPSS, IIEF and the sexual part of the EPIC questionnaires (assessing BPH severity, erectile and sexual function) a month before and after their surgery. Upon discharge, patients were advised to resume sexual activity whenever they desired without indicating a specific period of abstinence.

To study urologists' perspectives in this context, the authors approached board certified urologists, asking them to complete a short questionnaire assessing their current practice and recommendations. Overall, 70 urologists completed the questionnaire. More than 94% worked at academic centers, most had more than 10 years’ experience, and over 50% indicated performing at least 60 surgeries yearly. The results of their questionnaires demonstrated that more than 50% would recommend abstaining from any sexual activity for 1-3 month postoperatively.

Of the 71 participating patients, roughly half underwent endoscopic surgery. Over 80% of patients were older than 60 and over 90% were married. The postoperative IPSS improved significantly, while no difference was detected in the IIEF and EPIC scores. Almost all patients (94%) patients reported on resuming sexual activity less than a month postoperatively and more than 40% within 2 weeks. Two thirds reported on retrograde ejaculation and 11 % reported on mild bleeding. Although more than 20% experienced some pain during orgasm, only 10% decided to refrain temporarily from further sexual activity.

Dr. Goldberg concluded his presentation by stating that while most urologists recommend refraining from sexual activity for 1-3 months following BPH surgery, this study suggests that over 94% of patients may resume sexual activity shortly after surgery (<1 month), expecting minimal adverse side effects.

Presented By: Hanan Goldberg, Toronto, Canada

Written By: Hanan Goldberg, MD, Urologic Oncology Fellow (SUO), University of Toronto, Princess Margaret Cancer Centre

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA

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