Changes in Erectile Function after Photoselective Vaporization of the Prostate with a 120-W GreenLight High-Performance System Laser: 2-Year Follow-Up

Abstract

PurposeTo evaluate the impact of photoselective vaporization of the prostate (PVP) with a 120-W GreenLight high-performance system on erectile function in a 2-year follow-up study.Materials and MethodsOne hundred seventy-seven patients who underwent PVP during 2008 to 2012 were analyzed retrospectively. The patients were divided into 5 groups according to their preoperative 5-item International Index of Erectile Function (IIEF-5) scores: Group I (IIEF-5: 5~7, n=28), II (IIEF-5: 8~11, n=47), III (IIEF-5: 12~16, n=43), IV (IIEF-5: 17~21, n=34), and V (IIEF-5: 22~25, n=25). The patients were assessed before surgery and 6, 12, and 24 months after the PVP. Their International Prostate Symptom Score/quality of life, maximum urinary flow rate/post-void residual urine volume, and IIEF-5 scores were measured at each visit.ResultsThe mean age and presence of hypertension were significantly different among the 5 groups. Perioperative parameters and postoperative complication rates showed no statistical differences. After PVP, voiding parameters were significantly improved in all the groups and sustained during the 2-year follow-up. The postoperative IIEF-5 scores fell slightly overall, while group V showed the largest significant deterioration. In multivariate analysis, body mass index (BMI) was the only independent predictor of decreased erectile function after PVP.ConclusionsErectile function declined in all the groups after PVP, with the most extensive deterioration observed in patients with normal erectile function preoperatively. Preoperative BMI was the only independent risk factor for a meaningful decrease in erectile function after PVP.

Clinical efficacy and complications of transurethral resection of the prostate versus plasmakinetic enucleation of the prostate

“…The PVR and prostatic volume were measured by abdominal ultrasonography or transrectal ultrasound, respectively. Sexual function was evaluated by the International Index of Erectile Function (IIEF-5), and the score of IIEF-5 with less than 12 points was considered as typical erectile dysfunction [ 14 ]. During the course of follow-up, if a patient with one time of the absence in IPSS, QoL, Qmax, PVR, and IIEF-5, the absent value of a parameter can be filled by imputation or mean completer at the observation time of 1, 2, and 3 years.…”

Erectile Function of BPH Patients Undergoing a Laser Procedure Compared to a Standard Transurethral Resection of the Prostate (Turp): A Systematic Review and Meta-Analysis

“…This finding was in accordance with the study that used Thulium laser in which there was in-significant difference in erection function before and after BPH therapy using Thulium laser [18] In contrast with greenlight type laser, BPH treatment using laser therapy could reduce erection function in several studies. This result was probably due to the penetration ability from greenlight laser which is theoritically deeper compared to holmium or thulium laser [24].…”

Evaluating the Impact of Benign Prostatic Hyperplasia Surgical Treatments on Sexual Health

“…The surgical intervention for BPH often brings significant relief from urinary sy toms, yet it can also inadvertently impact sexual function. This worsening of sexual h post-surgery is attributed to a variety of mechanisms, each interplaying in a complex m ner [33][34][35][36][37][38]. To better understand these complexities, Figure 1 visually summarize key mechanisms through which surgical intervention for BPH may affect sexual func Injury to the internal urinary sphincter: The internal urinary sphincter, situ within the genitourinary tract, plays a pivotal role in the ejaculation process.…”