Sexual function data

Pre-operatively, 55% of the patients claimed to be potent in the year prior to surgery

while 76 patients (84%) reported an erection ‘a few times or more’ within

the month prior to surgery (table 13) , although 24 % (n=9) of the laser patients who

replied reported ‘difficulty maintaining an erection which prevented sexual intercourse

in the past month’ compared with 40% n=20 of the TURP patients , (table 14).

Table 15 shows the pre-operative replies to the question of how spoilt their sex life

had become as a result of perceived prostatic problems There were no statistically

significant associations at baseline between the extent to which patients felt their

sex life had been spoilt by their prostate problems and prostate volume , age or

whether the patient had been in retention pre-operatively .

Table 13 shows the patients’ responses to the question ‘over the past month have you

been able to have erections when you were sexually stimulated ?

There was no significant difference between the laser and TURP groups with regard to

these responses ; overall, 35 patients (39% reported an erection most of the time or

‘always’ during the past month .When asked whether they had difficulty maintaining an

erection, which prevented them from having intercourse , 9 of the laser patients (24%)

compared with 20 of the TURP patients (40%) reported this . However, more of the

laser patients did not attempt sexual intercourse (34% v 22% (Table 1 4 ).

There were no significant differences between the study groups with respect to how

spoilt their sex life had become as a result of their prostate problem

(table 15). Overall, 30 patients (33%) reported that their sex life had not been spoilt,

3 month post operative data

Overall 29 patients (40%) said their sex life had improved as a result of surgery There

was no significant difference between the two study groups : 44 % (n=14) of the laser

patients reported an improvement in their sex life , compared with 38% (n=15 ) of the

TURP group . 44% of the patients reported no change ; (laser 50% [n=14], TURP

40% [n=16] ).

4% (n=l)of the laser patients who had answered both at baseline and three months

and were potent pre-operatively , were impotent, compared with 3% (n=l) of the

TURP group (ns).

There was no association between prostate volume, age or pre-operative

catheterisation and the degree to which the patient reported his sex life had been spoilt

either overall or in the laser or the TURP groups separately.

Overall, there were significant associations between the three SF-36 domains of

energy/vitality , mental health and role limitation due to physical problems and the

degree to which the patients’ sex life remained spoilt (analysis of variance p=0.0001 ,

p=0.015 and p=0.05 respectively ). Those patients who reported worse SF-36 scores

had poorer sexual fiinction .

With regard to the extent that their ‘prostatic problem ‘ had spoilt their sex life , 38 %

( n=10) of the patients who answered ‘not at all’ changed their reply to ‘slightly’,

‘somewhat’ , ‘considerably’ or ‘completely’ following prostatectomy . Six of these

patients reported only a slight deterioration . Breaking these figures down by

operation , 22% of the laser patients who pre-operatively reported that their prostate

problem had not spoilt their sex life , said that it had been spoilt at three months ,

Considering sex life and satisfaction with treatment, overall there was a tendency for

those patients who were very satisfied to have no sexual problems , and for those who

were less satisfied to feel that their sex-life had been spoilt by surgery (Spearman

Correlation r=0.264 , n=90 , p=<0.012 ) .

On breaking these results down by treatment, this trend was evident for both

treatments , although it was only statistically significant for the TURP group

(Spearman r= 0.263 , n=46 , p= < 0.03 ) .

When asked ‘ Would you recommend this operation to a friend T ; overall 85% of the

patients would recommend the operation (n=108 ) . 93% (n=56) of those

patients who reported that their sex life had not been spoilt or only slightly spoilt said

they would have the operation, or would recommend it to a fiiend , compared with

69% (n=20) of those who claimed their sex life was somewhat or completely spoilt

(Fisher’s exact test p=0.004). There was no significant difference between treatment

groups with regard to this association .

Laser TURP

Pre-op 3 months Pre-op 3 months

Never 13.2% n=5 18.4% n=7 17.3% n-9 8.7% n=4

A few times 39.5% n=15 23.7% n=9 38.5% n=20 32.6% n=l 5 About half the time 5.3% n=2 2.6% n=l 7.7% n=4 15.2% n=7 Most of the time 15.8% n=6 28.9% n=ll 21.2% n= ll 26.1% n=12

Always 26.3% n=10 26.3% n=10 15.4% n=8 17.4% n=8

Table 13 - Response to the question ‘over the past month have you been able to have

Laser TURP

Pre-op 3 months Pre-op 3 months

Difficulty 24% 19% 40% 27% n=9 n=7 n=20 n=12 No difficulty 42% 46% 38.0% 49% n=16 n=17 n=19 n=22 Not attempted 34% 35% 22.0% 24% n=13 n=13 n=ll n = ll

Table 14- Have you had difficulty in maintaining an erection which has prevented you

from having sexual intercourse in the past month ?

Laser TURP

Pre-op 3 months Pre-op 3 months

Not at all 31.6% n=12 52.6% n=20 34.0% n=l8 23.9% n=ll Slightly 18.4% n=7 10.5% n=4 11.3% n=6 47.8 % n=22 Somewhat 26.3% n=10 15.8 % n=6 26.4% n=14 10.9% n=5 Considerably 18.4% n=7 10.5% n=4 20.8% n= ll 15.2% n=7

Completely 5.3% n=2 10.5% n=4 7.5% n=4 2.2% n=l

Table 15 - Response to the question ‘ to what extent do you feel that your sex life has