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We performed a systematic review of studies evaluating the impact of surgery for lower urinary tract symptoms suggestive of benign prostate enlargement (LUTS/BPE) on both erectile and ejaculatory functions. In June 2018, we searched for randomized controlled trials (RCTs) published between 1998 and 2018 in which both functions were assessed using questionnaires. Overall, 15 studies were identified. Pre-operatively, mean International Index of Erectile Function −5 (IIEF-5) and mean IIEF—Erectile Function (EF) scores ranged from 13.3 to 20.8, and from 13.7 to 22.3, respectively. At follow-up evaluations, mean IIEF-5 and mean IIEF-EF scores did not significantly vary (13.4 to 20.7 and 14.4 to 24.3, respectively). Mean baseline Male Sexual Health Questionnaire- Ejaculatory Disease function score at baseline and follow-up evaluations ranged from 8.7 to 10.6, and from 4.9 to 11.9, respectively. Ejaculatory …