Ejaculation-sparing versus non-ejaculation-sparing anatomic GreenLight laser enucleo-vaporization of the prostate:...

Area of Science:

• Urology
• Surgical Techniques
• Sexual Medicine

Background:

• Benign prostatic hyperplasia (BPH) affects a significant portion of aging men.
• Traditional surgical treatments for BPH can lead to ejaculatory dysfunction.
• Photo-selective vaporization of the prostate (PVP) is a common BPH treatment.

Purpose of the Study:

• To describe an ejaculation-sparing anatomic PVP technique.
• To compare outcomes of ejaculation-sparing versus non-ejaculation-sparing anatomic PVP.
• To identify predictors of preserved antegrade ejaculation.

Main Methods:

• A cohort of sexually active BPH patients undergoing anatomic PVP was divided into ejaculation-sparing (Group A) and control (Group B) groups.
• Data on lower urinary tract symptoms (LUTS) and sexual function were collected pre-operatively and at 6-month follow-up.
• Inverse probability of treatment weighting (IPTW) and logistic regression were used for analysis.

Main Results:

• No significant differences in peri-operative outcomes or high-grade complications were observed between groups.
• At 6-month follow-up, urinary and erectile function were similar between groups.
• Ejaculation-sparing PVP demonstrated superior Male Sexual Health Questionnaire (MSHQ) scores and higher antegrade ejaculation rates (60% vs. 13.1%).

Conclusions:

• The ejaculation-sparing anatomic PVP technique is superior in preserving ejaculatory function compared to standard PVP.
• This technique shows comparable efficacy in relieving LUTS at short-term follow-up.
• Preservation of antegrade ejaculation was strongly predicted by the ejaculation-sparing surgical approach.