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Published on: December 28, 2021
Erectile function following high-energy thick loop prostatectomy
1Department of Surgery, College of Medicine, and King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia. rftalic@ksu.edu.sa
Objectives:
To evaluate the effects of the high energy cutting current that is used in conjunction with the thick loop on erectile function in patients with benign prostatic hyperplasia (BPH) undergoing prostatectomy.
Patients And Methods:
Seventy patients with BPH were included in this prospective study. All patients underwent transurethral vaporization resection of the prostate (TUVRP) using the "Wing" thick loop and 250-Watt cutting current. Potency questionnaire to define if the patient was fully potent, partially potent or impotent was obtained both pre operatively and 3 months post-TUVRP. Adequate preoperative counseling on the procedure and its outcome particularly in relation to sexual activity was given to all patients that were sexually active. Age of the patients, size of the prostate, resectate weight and operation time was recorded for correlation with erectile function post-TUVRP.
Results:
The mean age of patients was 70.1 +/- 6.3 years, the mean prostate size was 53.9 +/- 31.1 grams. Thirty-two patients (46%) were either impotent or sexually inactive at presentation. Thirty men were fully potent and 8 patients presented with reduced potency. Only 2 patients (5.2%) developed impotence post-TUVRP, both were partially impotent at presentation.
Conclusions:
Our results indicate that the frequency of erectile dysfunction following TUVRP may be low. It seems that the higher energy use in TUVRP does not adversely affect potency possibly because of the cooling effect of the circulating blood in the neurovesical bundles and the use of irrigation fluids intraoperatively.
