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Peer-reviewedCC BY-NC-SACentral European journal of urology

Erectile and ejaculatory outcomes after HoLEP: A longitudinal analysis during the learning curve.

  • Luis E Ortega Polledo1,2
  • Sascha Ahyai3
  • Gómez Juan Rivas1,4,5
  • Enrique Redondo González1,4,5
  • Irene Serrano García6
  • Geo F J Bianchini Hernández2,7
  • Juan Carballo da Silva2,8
  • Rodrigo España Navarro9
  • Isabel Galante Romo1,4,5
  • Bernardino Miñana López10
  • Sergio Alonso Y Gregorio2
  • Jesús Moreno Sierra1,4,5
10 affiliations
  1. 1Hospital Clínico San Carlos, Servicio de Urología, Madrid, Spain.
  2. 2Instituto de Urología de la Peña-Hidalgo-Alonso, Madrid, Spain.
  3. 3Medical University of Graz, Department of Urology, Graz, Austria.
  4. 4Instituto de Investigación Sanitaria, Hospital Clínico San Carlos, Madrid, Spain.
  5. 5Universidad Complutense de Madrid, Spain.
  6. 6Unidad de Apoyo Metodológico a la Investigación, Hospital Clínico San Carlos, IdISSC, Madrid, Spain.
  7. 7Hospital Central de la Defensa Gómez Ulla, Madrid, Spain.
  8. 8Hospital Universitario de Guadalajara, Guadalajara, Spain.
  9. 9Hospital Regional Universitario de Málaga, Málaga, Spain.
  10. 10Clínica Universidad de Navarra, Servicio de Urología, Madrid, Spain.
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Abstract

Introduction

Holmium laser enucleation of the prostate (HoLEP) is a well-established surgical technique for benign prostatic obstruction. Although functional outcomes have been widely reported, data on sexual function during the learning phase remain limited. The aim of this study was to describe longitudinal erectile and ejaculatory outcomes during the initial learning curve of HoLEP.Material and methods

The first 254 consecutive patients undergoing HoLEP by a single surgeon were prospectively collected and retrospectively analyzed. Erectile function was evaluated using the Sexual Health Inventory for Men (SHIM) preoperatively and at 1, 3, 6, and 12 months. Ejaculatory function was assessed at the same intervals. Descriptive and comparative statistics were used, and patients were stratified into case groups to explore surgical experience impact.Results

A total of 254 patients were included. Mean patient age was 70.1 ±7.7 years and mean prostate volume was 90.9 ±34.4 cc. Preoperative SHIM scores were available for 222 patients, with a median of 12.7 [5.0-20.0]. SHIM decreased at 1 month (9 [3-15]) and recovered at 3 (12 [5-20]) and 6 months (13 [6-22]). At 12 months, erectile function remained stable (12 [5-20]) with no clinically relevant deterioration. Anejaculation was observed in 93.2% at 1 month and persisted throughout follow-up (>94%), with no significant differences across case groups.Conclusions

In this real-world HoLEP series, erectile function was preserved at mid-term follow-up, with a high and persistent rate of anejaculation. Sexual outcomes did not appear influenced by surgical experience.

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Cite

BibTeXRIS
BibTeX
@article{polledo2026erectile,
  title = {{Erectile and ejaculatory outcomes after HoLEP: A longitudinal analysis during the learning curve.}},
  author = {Luis E Ortega Polledo and Sascha Ahyai and Gómez Juan Rivas and Enrique Redondo González and Irene Serrano García and Geo F J Bianchini Hernández and Juan Carballo da Silva and Rodrigo España Navarro and Isabel Galante Romo and Bernardino Miñana López and Sergio Alonso Y Gregorio and Jesús Moreno Sierra},
  journal = {Central European journal of urology},
  year = {2026},
  month = jul,
  doi = {10.5173/ceju.2026.0061},
  url = {https://europepmc.org/article/MED/42904096},
  note = {CC BY-NC-SA},
}
RIS
TY  - JOUR
TI  - Erectile and ejaculatory outcomes after HoLEP: A longitudinal analysis during the learning curve.
AU  - Luis E Ortega Polledo
AU  - Sascha Ahyai
AU  - Gómez Juan Rivas
AU  - Enrique Redondo González
AU  - Irene Serrano García
AU  - Geo F J Bianchini Hernández
AU  - Juan Carballo da Silva
AU  - Rodrigo España Navarro
AU  - Isabel Galante Romo
AU  - Bernardino Miñana López
AU  - Sergio Alonso Y Gregorio
AU  - Jesús Moreno Sierra
PY  - 2026
DA  - 2026/07/18
JO  - Central European journal of urology
DO  - 10.5173/ceju.2026.0061
UR  - https://europepmc.org/article/MED/42904096
AB  - Introduction  Holmium laser enucleation of the prostate (HoLEP) is a well-established surgical technique for benign prostatic obstruction. Although functional outcomes have been widely reported, data on sexual function during the learning phase remain limited. The aim of this study was to describe longitudinal erectile and ejaculatory outcomes during the initial learning curve of HoLEP.Material and methods  The first 254 consecutive patients undergoing HoLEP by a single surgeon were prospectively collected and retrospectively analyzed. Erectile function was evaluated using the Sexual Health Inventory for Men (SHIM) preoperatively and at 1, 3, 6, and 12 months. Ejaculatory function was assessed at the same intervals. Descriptive and comparative statistics were used, and patients were stratified into case groups to explore surgical experience impact.Results  A total of 254 patients were included. Mean patient age was 70.1 ±7.7 years and mean prostate volume was 90.9 ±34.4 cc. Preoperative SHIM scores were available for 222 patients, with a median of 12.7 [5.0-20.0]. SHIM decreased at 1 month (9 [3-15]) and recovered at 3 (12 [5-20]) and 6 months (13 [6-22]). At 12 months, erectile function remained stable (12 [5-20]) with no clinically relevant deterioration. Anejaculation was observed in 93.2% at 1 month and persisted throughout follow-up (>94%), with no significant differences across case groups.Conclusions  In this real-world HoLEP series, erectile function was preserved at mid-term follow-up, with a high and persistent rate of anejaculation. Sexual outcomes did not appear influenced by surgical experience.
SN  - 2080-4806
SN  - 2080-4873
ER  -