Keyword: Erectile Function
2 results found.
Perspective Article
Journal of Urology and Andrology Research, 1(1), 2026, juar004
ABSTRACT:
Primary objective: To systematically evaluate and synthesize current clinical evidence on the impact of prostatic artery embolization (PAE) on erectile and ejaculatory function in men treated for benign prostatic hyperplasia (BPH).
Secondary objectives: To summarize, where reported, changes in prostate volume, PSA, IPSS/QoL, procedure-related adverse events, and cost-effectiveness data. These are presented separately from, and do not substitute for, the primary sexual-function analysis.
Materials and methods: A systematic review was conducted in accordance with the PRISMA 2020 statement. Four databases (PubMed/MEDLINE, Embase, Cochrane CENTRAL, Scopus) were searched to June 2026. Eligible studies were RCTs and prospective cohort studies reporting IIEF-5 and/or MSHQ-EjD outcomes with a minimum 3-month follow-up. Risk of bias was assessed with RoB 2 (randomized trials), ROBINS-I (non-randomized comparative studies), and the Newcastle–Ottawa Scale (single-arm cohorts). Certainty of evidence was evaluated using the GRADE approach. The protocol was not prospectively registered in PROSPERO (acknowledged as a limitation). Given clinical and methodological heterogeneity across studies, a quantitative meta-analysis was not performed; a narrative synthesis is presented.
Results: PAE was associated with a markedly lower rate of retrograde ejaculation (0–5%) than TURP or laser enucleation (56–85%), and with a stable-to-modestly-improved IIEF-5 score (+1.5 to +2.5 points at 12 months), attributed largely to LUTS relief and discontinuation of alpha-blockers/5-ARIs rather than a direct vascular effect on erectile tissue.
Conclusion: Current evidence supports PAE as an organ-preserving option with a superior sexual-function profile relative to TURP/HoLEP for sexually active men with BPH who prioritize preservation of antegrade ejaculation, though the certainty of this evidence is limited by open-label trial designs, non-validated outcome measures in several studies, and the absence of prospective registration.
Secondary objectives: To summarize, where reported, changes in prostate volume, PSA, IPSS/QoL, procedure-related adverse events, and cost-effectiveness data. These are presented separately from, and do not substitute for, the primary sexual-function analysis.
Materials and methods: A systematic review was conducted in accordance with the PRISMA 2020 statement. Four databases (PubMed/MEDLINE, Embase, Cochrane CENTRAL, Scopus) were searched to June 2026. Eligible studies were RCTs and prospective cohort studies reporting IIEF-5 and/or MSHQ-EjD outcomes with a minimum 3-month follow-up. Risk of bias was assessed with RoB 2 (randomized trials), ROBINS-I (non-randomized comparative studies), and the Newcastle–Ottawa Scale (single-arm cohorts). Certainty of evidence was evaluated using the GRADE approach. The protocol was not prospectively registered in PROSPERO (acknowledged as a limitation). Given clinical and methodological heterogeneity across studies, a quantitative meta-analysis was not performed; a narrative synthesis is presented.
Results: PAE was associated with a markedly lower rate of retrograde ejaculation (0–5%) than TURP or laser enucleation (56–85%), and with a stable-to-modestly-improved IIEF-5 score (+1.5 to +2.5 points at 12 months), attributed largely to LUTS relief and discontinuation of alpha-blockers/5-ARIs rather than a direct vascular effect on erectile tissue.
Conclusion: Current evidence supports PAE as an organ-preserving option with a superior sexual-function profile relative to TURP/HoLEP for sexually active men with BPH who prioritize preservation of antegrade ejaculation, though the certainty of this evidence is limited by open-label trial designs, non-validated outcome measures in several studies, and the absence of prospective registration.
Original Article
Journal of Urology and Andrology Research, 1(1), 2026, juar001
ABSTRACT:
Introduction: Peyronie's disease (PD) is characterized by the development of fibrous plaques within the tunica albuginea, leading to penile deformity and significant psychological distress. While various surgical options exist, plaque incision or excision with grafting remains the gold standard for correcting complex or severe curvatures (>60–70°). This review evaluates the clinical outcomes, technical success, and complication rates of various autograft materials.
Historically, dermal grafts were the first autografts used but have fallen out of favor due to high rates of penile shortening (45–70%) and de novo ED (up to 66.7%). Saphenous vein grafts (SVG) demonstrate an initial success rate of ~85.6%, though long-term follow-up indicates a decline in straightness and rising ED rates (22.5%). Tunica albuginea and tunica vaginalis grafts show high technical success (90–100%) with low metabolic demand. More contemporary options, specifically fascia (lata and temporalis) and buccal mucosa grafts (BMG), show superior outcomes. Fascia grafts report technical success rates near 100% with minimal shortening. BMG demonstrates a 94.1% success rate with low de novo ED (0–10%) and rapid tissue integration.
Historically, dermal grafts were the first autografts used but have fallen out of favor due to high rates of penile shortening (45–70%) and de novo ED (up to 66.7%). Saphenous vein grafts (SVG) demonstrate an initial success rate of ~85.6%, though long-term follow-up indicates a decline in straightness and rising ED rates (22.5%). Tunica albuginea and tunica vaginalis grafts show high technical success (90–100%) with low metabolic demand. More contemporary options, specifically fascia (lata and temporalis) and buccal mucosa grafts (BMG), show superior outcomes. Fascia grafts report technical success rates near 100% with minimal shortening. BMG demonstrates a 94.1% success rate with low de novo ED (0–10%) and rapid tissue integration.