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In men who need treatment for lower urinary tract symptoms, standard
surgery (transurethral resection of the prostate) results in lower
levels of sexual dysfunction and less pain or discomfort on ejaculation
compared with non-contact laser therapy or conservative management
(watchful waiting). In a multicentre randomised controlled trial of
various treatments for urinary tract symptoms Brookes and colleagues
(p 1059) found that erectile function was significantly improved after
standard surgery and pain on ejaculation was significantly less. Older
men who need treatment for urinary symptoms and want to retain or
improve sexual function may want to consider standard surgery rather
than non-contact laser therapy.