Ejaculatory function following transperineal laser ablation vs TURP for benign prostatic obstruction: a randomized...

Area of Science:

• Urology
• Minimally Invasive Surgery
• Sexual Health

Background:

• Benign prostatic obstruction (BPO) affects a significant portion of the aging male population.
• Traditional surgical treatments like transurethral resection of the prostate (TURP) can lead to undesirable side effects, notably ejaculatory dysfunction.
• There is a need for effective BPO treatments that minimize impact on sexual health.

Purpose of the Study:

• To compare the efficacy of transperineal interstitial laser ablation of the prostate (TPLA) versus TURP in preserving antegrade ejaculation.
• To evaluate the impact of TPLA and TURP on urinary symptoms, sexual function, and quality of life.

Main Methods:

• A single-center, prospective, randomized, open-label study comparing TPLA and TURP for BPO treatment.
• Patients were randomized into TPLA (experimental) and TURP (reference) groups.
• Primary endpoint: change in ejaculatory function (EJ-MSHQ) at 1 month. Secondary endpoints included IPSS, Qmax, IIEF-5, and VAS scores.

Main Results:

• TPLA preserved ejaculatory function in 96% of patients, with no significant change in EJ-MSHQ scores (P = 0.2).
• TURP resulted in a median 30% decrease in EJ-MSHQ scores (P = 0.01), with 18 patients reporting absence of antegrade ejaculation.
• Both procedures improved International Prostate Symptom Score (IPSS) and maximum urinary flow rate (Qmax), though TURP showed a greater Qmax improvement.

Conclusions:

• TPLA is a reliable treatment for BPO, demonstrating a high success rate in preserving antegrade ejaculation.
• TPLA offers significant relief from BPO symptoms while maintaining ejaculatory function, making it a favorable alternative to TURP for select patients.
• Further research can explore long-term outcomes and patient-reported satisfaction with TPLA.