Maxime Deslandes1, Clément Klein2, Thibault Marquette3, Vincent Comat4, Richard Mallet5, Bertrand Degraeve6, Vianney Houssin7, Arnauld Villers8, Franck Bladou2, Grégoire Robert2. 1. Urology CHU Bordeaux GH Pellegrin Centre Hospitalier Universitaire de Bordeaux, 33000, Bordeaux, France. Maxime.deslandes@chu-bordeaux.fr. 2. Urology CHU Bordeaux GH Pellegrin Centre Hospitalier Universitaire de Bordeaux, 33000, Bordeaux, France. 3. Urology CH Dax, Boulevard Yves du Manoir, 40100, Dax, France. 4. Urology CH Côte Basque, 13 Av. de L'Interne Jacques Loeb, 64100, Bayonne, France. 5. Urology Clinique Francheville, 4 Pl. Francheville, 24000, Périgueux, France. 6. Urology Polyclinique Grand Sud, 350, avenue St André de Codols, 30932, Nîmes, France. 7. Urology Clinique Médico-Chirurgicale de La Côte d'Opale, 173 Route de Desvres, 62280, Saint-Martin-Boulogne, France. 8. Urology CHRU Lille, 2 Av. Oscar Lambret, 59000, Lille, France.
Abstract
PURPOSE: Preserved sexual function is one of the endpoints of the surgical management of lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Our aim was to investigate the evolution of erectile function (EF) at 3 and 12 months after holmium laser enucleation of the prostate (HoLEP). METHODS: A multicentric retrospective study was performed including 235 sexually active patients who underwent HoLEP between January 2016 and June 2017. Evaluation of EF was carried out with the five-item version of the International Index of Erectile Function (IIEF-5) completed before surgery and at 3 and 12 months after surgery. A change of more than five points in either direction in the IIEF-5 score compared to baseline was considered as an improvement or impairment of EF. RESULTS: No significant differences were found between median pre-operative IIEF-5 and median scores at 3 and 12 months (p = 0.15 and p = 0.45). At 3 and 12 post-operative months, respectively, 10% and 13% of patients reported an improvement, whereas 15% and 16% reported an impairment. The reduction in IIEF-5 score was only statistically significant within the sub-group of patients with normal pre-operative EF (p < 0.001). In this sub-group, 15% of patients reported a decrease of more than five points in total IIEF-5 score. CONCLUSION: This multicentric evaluation confirmed that median IIEF-5 score was not significantly impaired after HoLEP. However, for patients with normal pre-operative EF, a significant decrease in EF after HoLEP was observed. These results may be taken into account when counselling patients before HoLEP.
PURPOSE: Preserved sexual function is one of the endpoints of the surgical management of lower urinary tract symptoms suggestive of benign prostatic hyperplasia. Our aim was to investigate the evolution of erectile function (EF) at 3 and 12 months after holmium laser enucleation of the prostate (HoLEP). METHODS: A multicentric retrospective study was performed including 235 sexually active patients who underwent HoLEP between January 2016 and June 2017. Evaluation of EF was carried out with the five-item version of the International Index of Erectile Function (IIEF-5) completed before surgery and at 3 and 12 months after surgery. A change of more than five points in either direction in the IIEF-5 score compared to baseline was considered as an improvement or impairment of EF. RESULTS: No significant differences were found between median pre-operative IIEF-5 and median scores at 3 and 12 months (p = 0.15 and p = 0.45). At 3 and 12 post-operative months, respectively, 10% and 13% of patients reported an improvement, whereas 15% and 16% reported an impairment. The reduction in IIEF-5 score was only statistically significant within the sub-group of patients with normal pre-operative EF (p < 0.001). In this sub-group, 15% of patients reported a decrease of more than five points in total IIEF-5 score. CONCLUSION: This multicentric evaluation confirmed that median IIEF-5 score was not significantly impaired after HoLEP. However, for patients with normal pre-operative EF, a significant decrease in EF after HoLEP was observed. These results may be taken into account when counselling patients before HoLEP.
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