252 Is Sexual Function Better Preserved After Water Vapor Thermal Therapy Or Medical Therapy For Lower Urinary Tract Symptoms Due To Benign Prostatic Hyperplasia?

Alpha blockers and 5-alpha reductase inhibitors are the mainstay of treatment for lower urinary tract symptoms (LUTS) attributed to benign prostatic hyperplasia (BPH). However, some men experience deterioration of sexual function with these agents. Water vapor thermal therapy (Rezūm System), a minimally invasive procedure for LUTS/BPH, serves as an efficacious alternative treatment while preserving sexual function. To compare sexual function over 3 years after treatment for LUTS/BPH either with continuous daily treatment with pharmaceutical agents, using cohorts from the Medical Therapy of Prostatic Symptoms (MTOPS) study, or with a single thermal therapy procedure, using cohort from the Rezūm trial. We used sexual function data from sexually active cohorts of the MTOPS study (1,209) randomized to doxazosin, finasteride, combination therapy and placebo, and sexually active men who received thermal therapy (86). Subjects from the two trials were matched by LUTS severity and prostate size. MTOPS study participants completed the Brief Male Sexual Function Inventory (BMSFI); men in Rezūm trial completed the International Index of Erectile Function (IIEF-15) and Male Sexual Health Questionnaire (MSHQ). Estimated mean changes from baseline were compared using a linear mixed repeated measures model with fixed effects for treatment and follow-up visits.