Effects on Ejaculation Preservation Using Low-Energy Pulsed Thulium:YAG Laser Anatomical Enucleation in High-Volume...

Area of Science:

• Urology
• Minimally Invasive Surgery
• Laser Technology

Background:

• Benign prostatic hyperplasia (BPH) significantly impacts lower urinary tract symptoms and quality of life.
• Traditional BPH treatments can compromise ejaculatory function.
• There is a need for effective BPH treatments that preserve sexual health.

Purpose of the Study:

• To evaluate the efficacy of a pulsed thulium:YAG laser anatomical enucleation technique for high-volume BPH.
• To assess the technique's impact on preserving antegrade ejaculation.
• To determine the procedure's effectiveness in relieving prostatic obstruction.

Main Methods:

• Prospective study of 50 high-volume BPH patients.
• Utilized a pulsed thulium:YAG laser for anatomical enucleation, sparing key structures.
• Assessed outcomes using IPSS, QoL, and MSHQ-EjD SF preoperatively and at 6 months postoperation.

Main Results:

• Significant improvements in International Prostate Symptom Index (IPSS) and Quality of Life (QoL) scores.
• Mean maximum flow rate (Qmax) significantly increased, with reduced postvoid residual (PVR) volume.
• Antegrade ejaculation was preserved in 70% of patients, with no significant negative impact on other ejaculatory parameters.

Conclusions:

• The pulsed thulium:YAG laser anatomical enucleation technique is a promising option for BPH treatment.
• This method effectively relieves obstruction while preserving antegrade ejaculatory function.
• Larger randomized controlled studies are needed to validate these findings for broader clinical adoption.