Sexual and ejaculatory function after holmium laser enucleation of the prostate and bipolar transurethral enucleation of the prostate: a single-center experience.
Carolina BebiMatteo TurettiElena LievoreFrancesco RipaMarco BilatoLorenzo RocchiniAndrea GallioliMatteo Giulio SpinelliElisa De LorenzisGiancarlo AlboFabrizio LongoFranco GaddaPaolo Guido Dell'OrtoEmanuele MontanariLuca BoeriPublished in: International journal of impotence research (2020)
Currently available surgical treatments for Lower Urinary Tract Symptoms (LUTS) due to Benign Prostatic Obstruction (BPO) are associated with an increased risk of sexual dysfunction. The aim of our study is to compare sexual and ejaculatory function after Holmium Laser Enucleation of the Prostate (HoLEP) and Bipolar Transurethral Enucleation of the Prostate (B-TUEP). We performed a retrospective analysis of data prospectively collected from 62 (44.9%) and 76 (55.1%) patients who underwent HoLEP and B-TUEP, respectively. Erectile function and ejaculation characteristics were assessed with the International Index of Erectile Function-Erectile Function (IIEF-EF) domain and the Male Sexual Health Questionnaire-Ejaculatory function (MSHQ-EJ) questionnaires. Our study recorded no change in erectile function and no significant difference in rates of preserved antegrade ejaculation after both surgeries. One month after surgery, rates of physical pain/discomfort and perceived decreased physical pleasure during ejaculation were higher in HoLEP than B-TUEP patients (all p < 0.03). Moreover, HoLEP patients were more bothered by their ejaculatory difficulties than B-TUEP men (p = 0.03). At 3- and 12-months follow-up, all ejaculation-related differences disappeared. In conclusion, both procedures are valid alternatives for BPO treatment as they offer comparable urinary and sexual outcomes in the long term. However, in the first month after surgery, HoLEP patients present with more ejaculatory difficulties.
Keyphrases
- benign prostatic hyperplasia
- lower urinary tract symptoms
- end stage renal disease
- prostate cancer
- newly diagnosed
- ejection fraction
- chronic kidney disease
- mental health
- prognostic factors
- type diabetes
- depressive symptoms
- spinal cord injury
- insulin resistance
- metabolic syndrome
- social support
- adipose tissue
- patient reported
- electronic health record
- smoking cessation
- drug induced
- weight loss
- deep learning
- glycemic control
- combination therapy
- data analysis