To investigate the sexual effects of innovative minimally invasive surgical treatments for BPH-related lower urinary tract symptoms (LUTS), with a focus on ejaculatory dysfunction (EjD). A database search with a 10-year time limit was conducted using MEDLINE on the PubMed Platform through February 20, 2020, examining minimally invasive treatment methods for BPH and their influence on EjD. Following the selection of the papers, researchers collected data for males who were randomised in 19 distinct studies, with findings in 40 independent published articles exploring minimally invasive BPH surgery and reporting EjD rates. Water vapour thermal treatment or Rezm, prostatic urethral lift (PUL) or UroLift®, prostate artery embolization (PAE), and Aquablation have all demonstrated acceptable rates of retrograde ejaculation after one year and had very few side effects. When compared to PAE and Aquablation, both PUL and Rezm exhibited lower rates.

With comparable postoperative sexual side effect profiles, physicians may choose whether treatment modality is best for patients based on effectiveness and cost-benefit. More randomised clinical studies are needed to assess the efficacy of innovative minimally invasive surgical treatments for BPH-related LUTS on ejaculation and sexual function.