Patient and Partner Sexual Outcomes After Transperineal Laser Ablation for Benign Prostatic Hyperplasia: A 12-Month Longitudinal Study

Background: Preservation of sexual function has become a central goal in the surgical management of benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS), yet the impact of treatment on the patient’s partner has rarely been examined. Transperineal laser ablation (TPLA) is an emerging, explicitly ejaculation-sparing technique with a favorable reported sexual function profile. Objective: In this retrospective, single-center, single-arm cohort study, we aimed to longitudinally evaluate erectile function, ejaculatory function and bother, and partner sexual function from the first postoperative week to 12 months after TPLA. Materials and Methods: This retrospective study was based on prospectively collected outcome data from 36 consecutive sexually active men who underwent ultrasound-guided TPLA (SoracteLite™/EchoLaser™) for moderate-to-severe LUTS/BPH, with assessments at postoperative weeks 1 and 2 and months 1, 3, 6, 9, and 12. Erectile function (IIEF-5), ejaculatory function and bother (MSHQ-EjD), and partner sexual function (Female Sexual Function Index, FSFI) were assessed longitudinally alongside IPSS, Qmax, post-void residual volume, and prostate volume. Results: Median baseline IPSS was 31 and prostate volume was 70 mL. IIEF-5 declined transiently at weeks 1 and 2 (both p < 0.001), returned to baseline by month 1, and did not differ significantly from baseline thereafter, consistent with preservation of erectile function. MSHQ-EjD function scores likewise declined transiently in the early postoperative period before rising modestly above baseline from month 3 onward (all p < 0.001, months 3–12), with a parallel change in the bother domain over the same period. Partner FSFI scores followed a similar temporal pattern, declining transiently during the first postoperative month, normalizing by month 3, and was slightly higher than baseline at month 12 (p < 0.05). IPSS improved from 31 to 8 and prostate volume decreased by a median of 52.5% at 12 months (both p < 0.001). No Clavien–Dindo grade ≥II complication occurred. Conclusions: In this retrospective single-arm cohort, TPLA was followed by substantial relief of severe LUTS. The findings are compatible with preservation of erectile function and a small increase in ejaculatory function scores, with partner sexual function following a parallel, non-causal trajectory. In the absence of a comparator group, these later changes cannot be attributed to TPLA itself and may partly reflect urinary symptom relief, medication changes, regression to the mean, or expectation effects. Controlled studies incorporating partner-reported outcomes are needed to determine whether TPLA confers couple-level sexual benefit.