ABSTRACT
【Objective】 To explore the effects of sexual function-preserving 450 nm blue laser vaporization of the prostate on the postoperative sexual function of patients with benign prostatic hyperplasia (BPH), and to evaluate the clinical efficacy, safety and feasibility of this procedure. 【Methods】 The clinical data of 20 BPH patients treated in our department during Jan. and Mar.2023 were analyzed. The International Prostate Symptom Score (IPSS), Quality of Life Scale (QoL) score, maximum urinary flow rate (Qmax), residual urine volume (PVR) and International Index of Erectile Function (IIEF-5) data were compared before and after the operation. The operation time, postoperative catheter indwelling time, and hospital stay were recorded. The ejaculation status 2 months after operation was followed up. 【Results】 All 20 patients completed the operation successfully. The operation time was (13.41±4.30) min, catheter indwelling time (1.2±0.4) d, and hospital stay (3.0±0.6) d. The IPSS, QoL, PVR and Qmax data 1 month after operation were significantly improved compared with those before operation (P0.05). 【Conclusion】 The modified 450 nm blue laser vaporization of the prostate can improve the urination symptoms of BPH patients while retaining sexual function. It is a safe and feasible technique for BPH patients who have sexual needs, and provides an alternative surgical approach for those looking to preserve sexual function.
ABSTRACT
Dhat syndrome refers to a culture-bound syndrome of Southeast Asia, where patients present with anxiety and depressive and somatic symptoms, which they attribute to semen loss. Common presentation of these patients is the passage of semen-like substance in urine. Retrograde ejaculation may cause spermaturia, and patients with firmly held cultural myths related to sexuality may develop features of Dhat syndrome. Here, a patient with obsessive–compulsive disorder on treatment with fluoxetine developed retrograde ejaculation and subsequently features of Dhat syndrome.
ABSTRACT
@#This is a case of a 37-year-old nulliparous woman, and her 53-year-old husband diagnosed with complete retrograde ejaculation and absolute azoospermia, who conceived after transfer of embryos fertilized using cryopreserved sperm retrieved from postejaculatory urine. Four embryos were thawed, then transferred in the blastocyst stage, resulting in a singleton pregnancy and delivery by cesarean section at term to a healthy baby boy weighing 3100 g. This case study shows that cryopreservation of sperm retrieved from postejaculatory urine is feasible for IVF, despite demonstration of low motility. This is more cost-effective and least invasive as the husband may avoid surgical aspiration or extraction of sperm.
Subject(s)
Cryopreservation , Infertility , Fertilization in VitroABSTRACT
n recent years, photoselective vaporization of the prostate (PVP) has gained a wide clinical application in the treatment of benign prostatic hyperplasia (BPH) for its satisfactory effect, high safety, and low incidence of complications. With the improvement of living conditions, BPH patients are paying more attention to their sexual function, especially erectile function and ejaculatory problems instead of just focusing on the alleviation of lower urinary tract symptoms. Few studies of PVP, however, relate to its association with the sexual function of the patient and there is a certain controversy over the influence of PVP on it in the existing literature. Prevailing views hold that the uprated power in PVP does not affect erectile function or increase the risk of retrograde ejaculation (REj) and that PVP is even better than transurethral resection of the prostate (TURP) in avoiding the risk of REj.
Subject(s)
Aged , Humans , Male , Ejaculation , Laser Therapy , Methods , Lower Urinary Tract Symptoms , Therapeutics , Penile Erection , Prostate , General Surgery , Prostatic Hyperplasia , General Surgery , Sexual Dysfunctions, Psychological , Transurethral Resection of Prostate , Treatment OutcomeABSTRACT
Objective To evaluate the impact of 120 W 2 μ m continuous-wave laser vapoenucleation versus and transurethral resection of the prostate (TURP) in patients with symptomatic benign prostatic hyperplasia (BPH) on sexual function.Methods One hundred and twenty-two patients with BPH were selected,63 cases were treated with 120 W 2 μ m continuous-wave laser vapoenucleation versus(2 μ m laser group),59 cases were treated with TURP(TURP group).International index of erectile function(IIEF) scores and self-made general assessment questions were completed before and 12 months after treatment to determine the impact on sexual function.IIEF scores included erectile function (EF),sexual desire,orgasm,sexual satisfaction and overall satisfaction.Results The IIEF scores difference was no significant before treatment between two groups (P ＞ 0.05).In two groups,there was no significant difference in EF,sexual desire,sexual satisfaction and overall satisfaction score between before treatment and 12 months after treatment(P＞ 0.05),orgasm score 12 months after treatment was significantly lower than that before treatment [2 μm laser group:(5.9 ± 1.5) scores vs.(8.6 ± 2.7) scores;TURP group:(5.5 ± 1.6) scores vs.(8.7 ± 1.8) scores] (P ＜0.05).Multiple linear regression analysis showed that two groups EF score and the international prostate symptom score,quality of life score and Q.~ positive linear correlation.Logistic regression analysis showed that the incidence of retrograde ejaculation and orgasm reduced significantly assoeiated(P ＜ 0.05),as an independent predictor of orgasm reduced after treatment(P ＜ 0.05).Conclusions There is no difference between these two surgical techniques regarding to impact on sex function.No significant EF improvement after surgery in both groups,but these two techniques can significantly decrease the IIEF orgasmic function domain and this is mainly caused by retrograde ejaculation.
ABSTRACT
Retrograde ejaculation, semen flows into the bladder because of failure of the bladder neck to close, is to uncommon cause of male infertility. Many pregnancies have been tried by artificial intrauterine insemination of the wife with the husband's sperm recovered from voided urine. Major problems that use of retrograde ejaculation specimens for artificial insemination are (1) the acidity of the urine, (2) the osmotic pressure of the urine, (3) the dilution effect caused by the urine, and (4) urine contamination of the cell suspension. We report a case of successful pregnancy using Ham's F-10 medium, which contained 10% cord in the retrograde ejaculation patient.