title: Sexual outcome of patients undergoing thulium laser enucleation of the prostate for benign prostatic hyperplasia.
abstract: 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.
authors: Academic Department of Urology, IRCCS Policlinico San Donato, University of Milan, Milan, Italy.
authors: Luca
authors: L
authors: Carmignani
authors: Giorgio
authors: G
authors: Bozzini
authors: Alberto
authors: A
authors: Macchi
authors: Serena
authors: S
authors: Maruccia
authors: Stefano
authors: S
authors: Picozzi
authors: Stefano
authors: S
authors: Casellato
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004542:Ejaculation / Q000502:physiology; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D053844:Lasers, Solid-State / Q000627:therapeutic use; D059411:Lower Urinary Tract Symptoms / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000601:surgery; D011470:Prostatic Hyperplasia / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D011788:Quality of Life; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D013932:Thulium; D016896:Treatment Outcome
chemical_list: D013932:Thulium
references: J Endourol. 2010 Dec;24(12):2051-7
references: 20964486
references: Urology. 2002 Oct;60(4):623-7
references: 12385922
references: Asian J Androl. 2009 May;11(3):277-81
references: 19398957
references: Eur Urol. 2006 Jun;49(6):961-9
references: 16632179
references: Urology. 2012 Nov;80(5):1098-104
references: 23107401
references: Eur Urol. 2006 Sep;50(3):569-73
references: 16704894
references: Eur Urol. 2010 Sep;58(3):384-97
references: 20825758
references: J Endourol. 2012 Oct 9;:null
references: 22849319
references: BMJ. 2002 May 4;324(7345):1059-61
references: 11991908
references: Int Urol Nephrol. 2012 Apr;44(2):359-64
references: 21779921
references: J Androl. 2007 Mar-Apr;28(2):259-61
references: 17021335
references: J Urol. 2011 Dec;186(6):2323-7
references: 22014812
references: Eur Urol. 2003 Dec;44(6):637-49
references: 14644114
references: Urology. 2007 May;69(5):805-9
references: 17482908
references: J Endourol. 2005 Jan-Feb;19(1):25-31
references: 15735378
references: Eur Urol. 1998 Dec;34(6):480-5
references: 9831789
references: Eur Urol. 2008 Feb;53(2):382-89
references: 17566639
references: N Engl J Med. 1995 Jan 12;332(2):75-9
references: 7527493
references: Korean J Urol. 2012 Feb;53(2):104-8
references: 22379589
references: Urology. 2008 Feb;71(2):247-51
references: 18308094
references: Urol Int. 2012;88(2):165-9
references: 22237486
references: J Urol. 2004 Nov;172(5 Pt 1):1926-9
references: 15540757
references: Eur Urol. 2013 May;63(5):859-67
references: 23245687
references: J Sex Med. 2008 Nov;5(11):2669-71
references: 18785895
references: World J Urol. 2010 Feb;28(1):45-51
references: 20063164
references: J Urol. 2012 Jul;188(1):216-21
references: 22591968
references: BJU Int. 2002 Feb;89(3):208-13
references: 11856100
references: J Urol. 2006 May;175(5):1817-21
references: 16600770
references: Eur Urol. 2010 Aug;58(2):207-11
references: 20466480
references: BJU Int. 2010 Apr;105(7):964-9
references: 19912196
references: J Urol. 1996 Oct;156(4):1354-6
references: 8808870
references: J Endourol. 1998 Oct;12(5):457-9
references: 9847070
references: Eur Urol. 2013 Jul;64(1):118-40
references: 23541338
references: J Urol. 2008 Jul;180(1):246-9
references: 18499179