Long-term sexual outcomes after holmium laser enucleation of the prostate: which patients could benefit the most?

Capogrosso, Paolo; Ventimiglia, Eugenio; Ferrari, Matteo; Serino, Alessandro; Boeri, Luca; Capitanio, Umberto; Briganti, Alberto; Damiano, Rocco; Montorsi, Francesco; Salonia, Andrea

doi:10.1038/ijir.2016.29

Cited by 16 publications

(19 citation statements)

References 33 publications

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“…Similar results were also obtained by Capogrosso et al. [31] in patients undergoing enucleation procedure.…”

Section: Discussionsupporting

confidence: 89%

Bipolar transurethral enucleation and resection of the prostate: Whether it is ready to supersede TURP?

Chen

et al. 2018

Asian Journal of Urology

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ObjectiveAccording to the EAU Guidelines, transurethral resection of the prostate (TURP) has so far still been considered as the gold standard for surgical treatment for patients with obstructing clinical benign prostate hyperplasia (BPH). However, its relatively high rate of complications and postoperative recurrence necessitates further modification and innovation on the surgery technique. We reported the patient outcomes with our technique.MethodsWe retrospectively analyzed 52 patients with obstructing clinical BPH who underwent bipolar transurethral enucleation and resection of the prostate (B-TUERP) between March 2015 and September 2015. Pre- and perioperative parameters were obtained from medical charts. Postoperative follow-ups were administrated at 1, 3, 6, 12 and 24 month(s) after surgery, respectively.ResultsAll the operations were performed successfully with a mean operative time of 43.1 min and an average tissue removal rate of 74.7%. Qmax was significantly improved immediately after surgery, followed by a continuous improvement throughout the follow-ups. Following a steep decrease in mean prostate specific antigen (PSA) and post void residual (PVR) observed within the first half year after surgery, the serum PSA was then maintained at a constant level of 0.61 ng/mL. Temporary urinary retention was found in four cases (7.7%). Stress urinary incontinence occurred in five patients (9.6%), with the condition resolved in 1–2 weeks without extra treatment. Urethral strictures and bladder neck contractures, as the most commonly observed long-term complications, developed in four patients (7.7%). No recurrence was found during 2 years of follow-ups. An improvement in International Index of Erectile Function (IIEF-5) scores was witnessed in 17 patients preoperatively with normal sexual function during the first 6 months after surgery, and sustained throughout the 24-month period.ConclusionsEnucleation reflects an improvement on surgical technique in many ways with a need for surgical equipment that can be broadly accessible in clinical practice. Currently, bipolar resection is a commonly employed procedure in clinical settings, and its similarity shared with bipolar enucleation technique warrants a quick learning of B-TUERP by urologists. Based on these findings, we believe that the substitution of TURP by TUERP as the gold standard for prostate endoscopic procedure can be expected in the future.

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“…Similar results were also obtained by Capogrosso et al. [31] in patients undergoing enucleation procedure.…”

Section: Discussionsupporting

confidence: 89%

Bipolar transurethral enucleation and resection of the prostate: Whether it is ready to supersede TURP?

Chen

et al. 2018

Asian Journal of Urology

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“…Long-term sexual outcomes showed that the patients with more severe preoperative urinary symptoms and ED would be more likely to have a clinically meaningful EF improvement, which was attributed to a persistent amelioration of LUTS. 31 For the patients without preoperative ED, a relatively small, but still significant, negative effect on erections in the early period after HoLEP was reported. 8 Thus, it is still controversial for the impact on sexual functions between enucleation and resection of prostate.…”

Section: Discussionmentioning

confidence: 95%

Impact on Sexual Function of Endoscopic Enucleation vs Transurethral Resection of the Prostate for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis

Liu

Cheng

Zhuo

et al. 2020

Journal of Endourology

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Introduction: Although the transurethral resection of the prostate (TURP) has been regarded as the gold standard surgical option for lower urinary tract symptoms due to benign prostatic hyperplasia, the endoscopic enucleation of the prostate (EEP) with novel techniques is also recommended. However, whether there are differences on male sexual functions after these two procedures is still controversial. We performed this metaanalysis to investigate the impact on erectile function (EF) and ejaculation of EEP and TURP, and to explore the potential superiority between these two approaches. Materials and Methods: Literature search was conducted on Medline, Embase, and the Cochrane library, to obtain all relevant randomized controlled trials published before December 13, 2018. Outcome data were pooled and analyzed with Review Manager 5.3 to compare the International Index of Erectile Function 5 (IIEF-5) scores and retrograde ejaculation (RE) rates from short-to long-term follow-ups. Results: Ten articles with 1435 patients were included. EEP group showed higher IIEF-5 scores than TURP group with mean difference (MD) = 1.00, confidence interval (95% CI): 0.95-1.05 at 48 months and MD = 1.08, 95% CI: 1.03-1.13 at ‡60 months, respectively. In subgroup analysis, the holmium laser enucleation of the prostate showed significantly better IIEF scores than TURP group at 48 months (MD = 1.00, 95% CI: 0.95-1.05) and ‡72 months (MD = 1.08, 95% CI: 1.03-1.13). Additionally, no significant difference in RE rate was found between EEP and TURP (risk ratio = 1.02, 95% CI: 0.85-1.23). Conclusions: Compared with TURP, EEP may produce a more durable benefit for postoperative preservation of EF at long-term stage.

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“…Long‐term sexual outcomes were published by Capogrosso et al. (2016). The group reported the IIEF‐EF outcomes of 135 sexually active men with a mean follow‐up of 152 months.…”

Section: Erectile Functionmentioning

confidence: 99%

Sexual outcomes of endoscopic enucleation of prostate

Cheng

2020

Andrologia

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The emergence of various endoscopic enucleation techniques in the past decade has provided surgeons with more options and opportunities in performing enucleation. With the same surgical principle as holmium laser enucleation of prostate, the early results of different techniques were comparable. However, sexual outcomes of endoscopic enucleation of the prostate (EEP) were less commonly reported than

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Long-term sexual outcomes after holmium laser enucleation of the prostate: which patients could benefit the most?

Cited by 16 publications

References 33 publications

Bipolar transurethral enucleation and resection of the prostate: Whether it is ready to supersede TURP?

Bipolar transurethral enucleation and resection of the prostate: Whether it is ready to supersede TURP?

Impact on Sexual Function of Endoscopic Enucleation vs Transurethral Resection of the Prostate for Lower Urinary Tract Symptoms Due to Benign Prostatic Hyperplasia: A Systematic Review and Meta-Analysis

Sexual outcomes of endoscopic enucleation of prostate

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