Within-Patient Association between Improvement in Lower Urinary Tract Symptoms and Change in Sexual Function after Prostatic Artery Embolization

This single-center retrospective study examined whether urinary symptom improvement after patients after prostatic artery embolization (PAE) for lower urinary tract symptoms secondary to benign prostatic hyperplasia was associated with erectile or ejaculatory function change. Urinary symptoms severity (International Prostate Symptom Score [IPSS]), erectile function (Sexual Health Inventory for Men [SHIM]), and ejaculatory function (Male Sexual Health Questionnaire-Ejaculatory Dysfunction [MSHQ-EjD]) were assessed at baseline and at 3 and 12 months in 183 patients. Mean IPSS improved by 12.0 points. After adjustment for age, baseline score, medications, and comorbidities, greater IPSS improvement was associated with greater SHIM improvement at the first (partial r = -0.17; P = .025) and second (partial r = -0.25; P = .020) follow-up, strengthening in the baseline erectile dysfunction subgroup (partial r = -0.38; P = .008). Within that subgroup, strong urinary responders more often achieved the SHIM minimal clinically important difference (26.3% vs 3.8%; P = .014). No association was found with ejaculatory function.