Souhil Lebdai1, Armand Chevrot2, Steeve Doizi3, Benjamin Pradere4, Nicolas Barry Delongchamps5, Amine Benchikh6, Jean Nicolas Cornu7, Emmanuel Della Negra8, Marc Fourmarier9, Vincent Misraï10, Pierre Etienne Theveniaud11, Aurélien Descazeaud12, Grégoire Robert13. 1. Urology Department, University Hospital of Angers, CHU Angers, 4 rue Larrey, 49933, Angers Cedex 9, France. souhil.lebddai@gmail.com. 2. Urology Department, University Hospital of Nimes, 30900, Nîmes, France. 3. Urology Department, Hôpital Européen Georges Pompidou, Paris, France. 4. Urology Department, University Hospital of Tours, Tours, France. 5. Urology Department, University Hospital of Cochin, 75014, Paris, France. 6. Urology Department, Clinique les Martinets, Versailles, France. 7. Urology Department, University Hospital of Rouen, Rouen, France. 8. Urology Department, Hôpital des Côtes d'Armor, Saint Brieuc, France. 9. Urology Department, Hospital of Aix en Provence, 13001, Aix en Provence, France. 10. Urology Department, Clinique Pasteur, Toulouse, France. 11. Urology Department, Saint Joseph Hospital, Paris, France. 12. Urology Department, University Hospital of Limoges, Limoges, France. 13. Urology Department, University Hospital of Bordeaux, Bordeaux, France.
Abstract
PURPOSE: Ejaculatory dysfunction is the most common side effect related to surgical treatment of benign prostatic obstruction (BPO). Nowadays, modified surgical techniques and non-ablative techniques have emerged with the aim of preserving antegrade ejaculation. Our objective was to conduce a systematic review of the literature regarding efficacy on ejaculatory preservation of modified endoscopic surgical techniques, and mini-invasive non-ablatives techniques for BPO management. METHODS: A systematic review of the literature was carried out on the PubMed database using the following MESH terms: "Prostatic Hyperplasia/surgery" and "Ejaculation", in combination with the following keywords: "ejaculation preservation", "photoselective vaporization of the prostate", "photoselective vapo-enucleation of the prostate", "holmium laser enucleation of the prostate", "thulium laser", "prostatic artery embolization", "urolift", "rezum", and "aquablation". RESULTS: The ejaculation preservation rate of modified-TURP ranged from 66 to 91%. The ejaculation preservation rate of modified-prostate photo-vaporization ranged from 87 to 96%. The only high level of evidence studies available compared prostatic urethral lift (PUL) and aquablation versus regular TURP in prospective randomized-controlled trials. The ejaculation preservation rate of either PUL or aquablation compared to regular TURP was 100 and 90 versus 34%, respectively. CONCLUSIONS: Non-ablative therapies and modified endoscopic surgical techniques seemed to be reasonable options for patients eager to preserve their ejaculatory functions.
PURPOSE: Ejaculatory dysfunction is the most common side effect related to surgical treatment of benign prostatic obstruction (BPO). Nowadays, modified surgical techniques and non-ablative techniques have emerged with the aim of preserving antegrade ejaculation. Our objective was to conduce a systematic review of the literature regarding efficacy on ejaculatory preservation of modified endoscopic surgical techniques, and mini-invasive non-ablatives techniques for BPO management. METHODS: A systematic review of the literature was carried out on the PubMed database using the following MESH terms: "Prostatic Hyperplasia/surgery" and "Ejaculation", in combination with the following keywords: "ejaculation preservation", "photoselective vaporization of the prostate", "photoselective vapo-enucleation of the prostate", "holmium laser enucleation of the prostate", "thulium laser", "prostatic artery embolization", "urolift", "rezum", and "aquablation". RESULTS: The ejaculation preservation rate of modified-TURP ranged from 66 to 91%. The ejaculation preservation rate of modified-prostate photo-vaporization ranged from 87 to 96%. The only high level of evidence studies available compared prostatic urethral lift (PUL) and aquablation versus regular TURP in prospective randomized-controlled trials. The ejaculation preservation rate of either PUL or aquablation compared to regular TURP was 100 and 90 versus 34%, respectively. CONCLUSIONS: Non-ablative therapies and modified endoscopic surgical techniques seemed to be reasonable options for patients eager to preserve their ejaculatory functions.