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Sexual outcome of patients undergoing thulium laser enucleation of the prostate for benign prostatic hyperplasia

Asian Journal of Andrology 2015年第5期17卷 802-806,I0009页

作者： Luca Carmignani Giorgio Bozzini Alberto Macchi Serena Maruccia Stefano Picozzi Stefano Casellato Academic Department of Urology IRCCS Policlinico San Donato University of Milan Milan Italy

Treatment of patients with lower urinary tract symptoms （LUTS） secondary to benign prostatic hyperplasia （BPH） may affect the quality of sexual function and ejaculation. The effect of new surgical procedures, which are currently available to treat BPH, on erection and ejaculation, has been poorly studied. This study aimed to assess the effect of thulium laser enucleation of the prostate （ThuLEP） on sexual function and retrograde ejaculation in patients with LUTS secondary to BPH. We performed a prospective study in 110 consecutive patients who had undergone ThuLEP to analyze changes in sexual function and urinary symptoms. To evaluate changes in erection and ejaculation, and the effect of urinary symptoms on the quality of life （QoL）, five validated questionnaires were used： the ICIQ-MLUTSsex, MSHQ-EjD, International Index of Erectile Function 5, International Prognostic Scoring System （IPSS） questionnaire, and QoL index of the intraclass correlation coefficients. Patients also underwent IPSS and flowmetry to assess the outcome of flow. Patients were evaluated before surgery and 3-6 months after ThuLEP, whereas those with previous abdominal surgery were excluded. The patients＇ mean age was 67.83 years. Postoperative urinary symptoms improved after surgery. No significant differences in erectile function before and after surgery were observed. As compared with other techniques described in the literature, the percentage of patients with conserved ejaculation increased by 52.7% after ThuLEP. ThuLEP positively affects urinary symptoms and their effect on the QoL of patients as assessed by questionnaire scores. While endoscopic management of BPH （e.g. transurethral resection of the prostate） causes retrograde ejaculation in most patients, those who undergo ThuLEP have conserved ejaculation and erectile function.

关键词： antegrade ejaculation benign prostatic hyperplasia sexual function thulium laser enucleation of the prostate

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Feasibility of en bloc thulium laser enucleation of the prostate in a large case series. Are results enhanced by experience?

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Asian Journal of Urology 2019年第4期6卷 339-345页

作者： Giovanni Saredi Giacomo Maria Pirola Francesca Ambrosini Simone Barbieri Lorenzo Berti Andrea Pacchetti Domenico Iovino Giuseppe Ietto Letizia Libassi Giulio Carcano Department of Urology Ospedale di Circolo e Fondazione MacchiVareseItaly Department of Urology Usl Toscana Sud EstSan Donato HospitalArezzoItaly Centro Cardiologico Monzino IRCCSMilanItaly Department of Urology University of GenovaGenovaItaly Department of Surgery University of InsubriaVareseItaly

Objective:To provide the first large single-operator case series of patients who undergo“en bloc”thulium laser enucleation of the prostate(ThuLEP)and to demonstrate an improvement in enucleation efficacy with ***:We prospectively evaluated a cohort of patients with symptomatic benign prostatic hyperplasia(BPH)who underwent“en bloc”ThuLEP between May 2015 and November *** between dependent variables(delivered energy and operating time)and independent variables(adenoma volume and experience)were estimated with regression *** experience was calculated as the time interval between the date of the first operation of the series and the date of the operation being ***:A total of 100 patients were registered for the *** operative time was 56.5 min(interquartile range[IQR]:40-85 min).Median enucleation time was 17.4 min(IQR:15-21.5 min).Median enucleation index(enucleation time per adenoma gram)was 0.3 min/g(0.2-0.3 min/g).The overall operative time is not influenced by experience,but we registered a significant trend towards a reduction in the total amount of energy delivered energy normalized per adenoma gram(p=0.0148).Conclusion:We believe that further attention is needed for these new“en bloc”prostatic enucleation techniques,which can facilitate some surgical steps,leading to a widespread use of laser technology for BPH surgical treatment.

关键词： Benign prostatic hyperplasia Endoscopic enucleation of the prostate laser surgery thulium laser enucleation of the prostate

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