Evaluating outcomes of combined bladder neck and supramontanal sparing ejaculatory preserving transurethral resection of the prostate: Results from a prospective, randomised study

Manasa, T; Reddy, Nishith R.; Puvvada, Sandeep; Mylarappa, Prasad

doi:10.5173/ceju.2022.0004

Cited by 2 publications

(1 citation statement)

References 14 publications

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“…Initially, studies confirmed the maintenance of erectile function in patients who underwent minimally invasive methods of BPH treatment. Subsequently, while considering the physiological mechanism of ejaculation, certain attempts were made to preserve anterograde ejaculation during monopolar transurethral resection of the prostate 22,23 . The use of a modified surgical technique made it possible to reduce the incidence of retrograde ejaculation only in patients with small-sized BPH.…”

Section: Discussionmentioning

confidence: 99%

Impact of Endoscopic Laser Vapoenucleation of Benign Prostatic Hyperplasia on Sexual Function

PLESACOV,

DUMBRAVEANU,

GHICAVII

2023

Arch Balk Med Union

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Impact de la vapoénucléation endoscopique au laser de l'hyperplasie bénigne de la prostate sur la fonction sexuelleIntroduction. L'hyperplasie bénigne de la prostate est une pathologie très fréquente, provoquant des symptômes du bas de l'appareil urinaire et des dysfonctionnements sexuels. Le traitement chirurgical de l'hyperplasie bénigne de la prostate est devenu très diversifié. De nouvelles méthodes endo-urologiques permettent à la fois de traiter efficacement l'hyperplasie bénigne de la prostate et de maintenir les fonctions sexuelles en postopératoire. L'objectif de l'étude a été d'evaluer les possibilités de maintenir la fonction éjaculatoire chez les patients atteints d'hyperplasie bénigne de la prostate subissant une vapoénucléation de la prostate au laser Thulium:YAG.

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Section: Discussionmentioning

confidence: 99%

Impact of Endoscopic Laser Vapoenucleation of Benign Prostatic Hyperplasia on Sexual Function

PLESACOV,

DUMBRAVEANU,

GHICAVII

2023

Arch Balk Med Union

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Comparing outcomes of Aquablation versus holmium laser enucleation of prostate in the treatment of benign prostatic hyperplasia: A network meta‐analysis

Bhatia,

Titus,

Porto

et al. 2024

BJUI Compass

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IntroductionWater Jet Ablation Therapy (WJAT) and Holmium Laser Enucleation of the Prostate (HoLEP) represent two common surgical treatments for Benign Prostatic Hyperplasia (BPH). Despite their increasing use, there is no study between these two methods. We aim to evaluate their efficacy and safety through a network meta‐analysis (NMA), providing critical insights for clinical decision‐making in the management of moderate to severe lower urinary tract symptoms (LUTS) due to BPH.MethodsPubmed, EMBASE and Cochrane Library were searched. Randomized controlled trials and prospective single‐arm studies comparing WJAT and HoLEP with TURP, reporting symptom scores, flow rates and adverse events. Data extraction and quality assessments were independently performed. Bayesian modelling in RStudio was used for statistical analysis, evaluating continuous outcomes through mean difference and categorical variables via risk ratios. Risk‐of‐Bias (RoB) and GRADE assessments were performed.FindingsTwenty‐three studies were included (WJAT‐11, HoLEP‐12). Most studies were at some or high risk of bias. At 12 months, the IPSS, Qol, PVR and Qmax improvements were 4.14 points (95% CI: ‐0.34 to 8.64, not‐significant [NS], GRADE‐rating: Low), 0.32‐points (95% CI:‐10.70 to 3.27, NS, GRADE‐rating: Low), 2.45 ml/s (95% CI: ‐1.85 to 7.05, NS, GRADE‐rating: Low), 63.10 ml (95% CI: 39.80 to 87.30, statistically‐significant [SS], GRADE‐rating: Moderate), respectively, all in favour of HoLEP. Haemoglobin‐loss was lower with HoLEP, 1.16 g/dl (95% CI: ‐2.56 to 0.54 mg/dl, NS, GRADE‐rating: Moderate) than WJAT. The risk of incontinence was higher with HoLEP; 4.48 (95% CI: 0.22 to 168.50, NS, GRADE‐rating: Very Low) than WJAT in single–arm analysis. The risk of blood transfusion was higher with WJAT (RR = 0.14; 95% CI: 0.00 to 4.21, NS, GRADE‐rating: Low) than HoLEP. Risk of Total Serious Adverse Events (Clavien‐Dindo grade>3) was higher with HoLEP (RR = 1.12, higher with HoLEP, 95% CI: 0.20 to 12.71, NS, GRADE‐rating: Low) than WJAT. Retreatment was lower with HoLEP (RR = 0.46, 95% CI: 0.02 to 10.54 GRADE‐rating: Low) than WJAT.InterpretationOur study suggests that both HoLEP and WJAT are effective treatments for BPH, both with similar IPSS and QoL improvements. HoLEP excels in functional outcomes, particularly in improving Qmax and PVR. Conversely, WJAT, with its shorter operation time and hospital stays, presents a compelling alternative, particularly for outpatient settings.

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Evaluating outcomes of combined bladder neck and supramontanal sparing ejaculatory preserving transurethral resection of the prostate: Results from a prospective, randomised study

Cited by 2 publications

References 14 publications

Impact of Endoscopic Laser Vapoenucleation of Benign Prostatic Hyperplasia on Sexual Function

Impact of Endoscopic Laser Vapoenucleation of Benign Prostatic Hyperplasia on Sexual Function

Comparing outcomes of Aquablation versus holmium laser enucleation of prostate in the treatment of benign prostatic hyperplasia: A network meta‐analysis

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