Does Greenlight HPS(™) laser photoselective vaporization prostatectomy affect sexual function?
OBJECTIVE
We evaluate the impact of GreenLight High-Performance System (HPS™) laser photoselective vaporization prostatectomy (PVP) on sexual function after treatment of lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH).


METHODS
We prospectively evaluated our initial single surgeon experience with GreenLight HPS™ laser PVP. All patients had American Urological Association Symptom Score (AUASS), Sexual Health Inventory for Men (SHIM), maximum flow rate (Qmax), and postvoid residual (PVR) determinations. Transurethral PVP was performed using a 120W GreenLight HPS™ side-firing laser system. AUASS, SHIM, Qmax, and PVR were evaluated 1, 4, 12, 24, and 52 weeks postsurgery. Wilcoxon signed rank test and the Student t-test were used to assess the changes from baseline.


RESULTS
Seventy-two patients completed 52 weeks of follow-up, having a median age of 69 (45-89) years. The median prostate volume was 62 (21-263) mL. Median AUASS improved significantly from 23 to 8, 6, 5, 5, and 4 (P < 0.05) at 1, 4, 12, 24, and 52 weeks, respectively. Median SHIM changed from 15 to 12, 16, 19, 16, and 17 during the follow-up period (P = 0.032, 0.427, 0.074, 0.081, and 0.259). Minimum change (0 ± 5) in SHIM occurred in 85.5%, 90.5%, 78.8%, 77.5%, and 73.7% of patients; 11.3%, 6.3%, 6.0%, 4.8%, and 7.0% of patients had deterioration of erectile function (SHIM reduction >5); and 3.2%, 3.2%, 15.2%, 17.7%, and 19.3% of patients had improvement of erectile function (SHIM increase >5). Incidence of new-onset retrograde ejaculation was 30%.


CONCLUSIONS
GreenLight HPS™ laser PVP appears to not have a detrimental effect on erectile function.
Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma 73104, USA.
Massimiliano
M
Spaliviero
Kurt H
KH
Strom
Xiao
X
Gu
Motoo
M
Araki
Daniel J
DJ
Culkin
Carson
C
Wong
D000368:Aged; D000369:Aged, 80 and over; D003710:Demography; D004542:Ejaculation / Q000502:physiology*; D006801:Humans; D053685:Laser Therapy / Q000009:adverse effects* / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000502:physiology*; D011300:Preoperative Care; D020728:Transurethral Resection of Prostate / Q000009:adverse effects* / Q000379:methods*; D016896:Treatment Outcome