Abstract: Objective · To study the effect of modified holmium laser enucleation of the prostate (HoLEP) on sexual function in patients with benign prostatic hyperplasia (BPH). Methods · The clinical data of 167 middle-aged and elderly patients with BPH treatedmodified HoLEP Feb. 2017 to Oct. 2018 were retrospectively analyzed. According to the status of sexual activity after operation, the patients were divided into study group who had sex (65 cases) and control group who had no sex (102 cases). The risk factors of sexual activity after operation in the two groups were analyzed. The changes of erectile function and ejaculatory function in the study group before and after operation were recorded and analyzedinternational index of erectile function (IIEF-5) score, erection hardness score (EHS) model and ejaculatory function questionnaire. Results · There were no significant differences between the two groups in the stress urinary incontinence, postoperative hospitalization time, weight of enucleated prostate, crush time, total prostate specific antigen, preoperative urinary retention and enucleation time. The patients in the study group were younger than those in the control group (P0.000). There were no significant differences in IIEF-5 score and EHS in the study group before and 1, 3, 6 months after operation. There were no significant differences in shorten ejaculation latency, ejaculation pain and ejaculation with or without semen in the study group before and after operation, but the patients of decreased semen volume increased 41.82% (23/55) to 92.73% (51/55) (P0.000). Conclusion · Age is a risk factor in BPH patients, whether there is sexual activity after modified HoLEP or not. The modified HoLEP has no significant effect on erectile function, but the effect on ejaculatory function is the decrease of ejaculated semen volume.

Key words: holmium laser enucleation of the prostate (HoLEP), benign prostatic hyperplasia (BPH), erectile function, ejaculation function