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This study investigated the correlation between periprostatic fat thickness(PPFT)measured on magnetic resonance imaging and lower urinary tract symptoms,erectile function,and benign prostatic hyperplasia(BPH)progression.A total of 286 treatment-naive men diagnosed with BPH in our department between March 2017 and February 2019 were included.Patients were divided into two groups according to the median value of PPFT:high(PPFT ＞4.35 mm)PPFT group and low(PPFT ＜4.35 mm)PPFT group.After the initial evaluation,all patients received a combination drug treatment of tamsulosin and finasteride for 12 months.Of the 286 enrolled patients,244 completed the drug treatment course.Patients with high PPFT had larger prostate volume(PV;P= 0.013),higher International Prostate Symptom Score(IPSS;P= 0.008),and lower five-item version of the International Index of Erectile Function(IIEF-5)score(P= 0.002)than those with low PPFT.Both high and low PPFT groups showed significant improvements in PV,maximum flow rate,IPSS,and quality of life score and a decrease of IIEF-5 score after the combination drug treatment.The decrease of IIEF-5 score was more obvious in the high PPFT group than that in the low PPFT group.In addition,more patients in the high PPFT group underwent prostate surgery than those in the low PPFT group.Moreover,Pearson's correlation coefficient analysis indicated that PPFT was positively correlated with age,PV,and IPSS and negatively correlated with IIEF-5 score;however,body mass index was only negatively correlated with IIEF-5 score.