Antegrade Ejaculation Preservation Technique with GreenLight XPS 180-W: Functional Ejaculatory Results

Area of Science:

• Urology
• Surgical Techniques
• Men's Health

Background:

• Ejaculatory dysfunction is a frequent complication following surgery for benign prostatic obstruction, significantly impacting patient quality of life.
• Preserving antegrade ejaculation (AE) is a key goal in surgical interventions for benign prostatic obstruction.

Purpose of the Study:

• To evaluate the efficacy of an antegrade ejaculation (AE) preservation technique during anatomical vaporization using the XPS 180-W system.
• To analyze patient-reported outcomes regarding ejaculatory function and satisfaction post-procedure.

Main Methods:

• A cohort of sexually active patients undergoing anatomical vaporization with XPS 180-W for benign prostatic obstruction between 2017 and 2019 were included.
• Ejaculatory function was assessed using the MSHQ-EjD Short Form questionnaire, with follow-up via mail, phone, or in-person contact.
• Voiding function was evaluated using International Prostatic Symptoms Score (IPSS), Qmax, and postvoid residual volume measurements.

Main Results:

• Of 112 patients, 77 (68.8%) completed the study. 88.3% of patients reported preserved antegrade ejaculation (AE), with 85.3% experiencing it most or all of the time.
• Patient satisfaction with ejaculatory function was significantly higher in those with preserved AE (0.97 vs. 2.7, p=0.000).
• Significant improvements were observed in voiding function parameters, including increased Qmax (11.6 vs. 19.6 mL/sec, p=0.00) and decreased IPSS (13.8 vs. 8.9, p=0.000) and postvoid residual volume (125.3 vs. 33.1 mL, p=0.00).

Conclusions:

• The antegrade ejaculation (AE) preservation technique using anatomical vaporization with XPS 180-W is feasible and effective.
• This technique demonstrates satisfactory patient-reported outcomes for both ejaculatory function and voiding function in patients with medium-sized prostates.