RESUMEN
Objective : To study the effect of modified holmium laser enucleation of the prostate (HoLEP) on sexual function in patients with benign prostatic hyperplasia (BPH). Methods ¡¤ The clinical data of 167 middle-aged and elderly patients with BPH treated by modified HoLEP from Feb. 2017 to Oct. 2018 were retrospectively analyzed. According to the status of sexual activity after operation, the patients were divided into study group who had sex (65 cases) and control group who had no sex (102 cases). The risk factors of sexual activity after operation in the two groups were analyzed. The changes of erectile function and ejaculatory function in the study group before and after operation were recorded and analyzed by international index of erectile function (IIEF-5) score, erection hardness score (EHS) model and ejaculatory function question-naire. Results ¡¤ There were no significant differences between the two groups in the stress urinary incontinence, postoperative hospitalization time, weight of enucleated prostate, crush time, total prostate specific antigen, preoperative urinary retention and enucleation time. The patients in the study group were younger than those in the control group (P=0.000). There were no significant differences in IIEF-5 score and EHS in the study group before and 1, 3, 6 months after operation. There were no significant differences in shorten ejaculation latency, ejaculation pain and ejaculation with or without semen in the study group before and after operation, but the patients of decreased semen volume increased from 41.82% (23/55) to 92.73% (51/55) (P=0.000). Conclusion ¡¤ Age is a risk factor in BPH patients, whether there is sexual activity after modified HoLEP or not. The modified HoLEP has no significant effect on erectile function, but the effect on ejaculatory function is the decrease of ejacu-lated semen volume.
RESUMEN
Introduction: Transurethral resection of the prostate (TURP) has been considered as the gold standard treatment for obstructive voiding dysfunction in men with benign prostatic hyperplasia. This standard treatment has been challenged by consistent data demonstrating the superiority of Holmium enucleation of the prostate (HoLEP). We review summarizes the literature comparing HoLEP to traditional therapies TURP, open prostatectomy (OP) for BPH these are widely used and have long term efficacy data. Patients undergoing HoLEP have significant shortened catheterization times, decreased length of hospital stay, fewer serious postoperative complications, greater reduction in post-operative IPSS, greater improvements in post-operative Qmax and lower rates of repeat endoscopic procedures for recurrent symptoms compared with TURP and OP. Furthermore, HoLEP can be used to resect more than 100 grams tissue and it is equivalent efficacy to open prostatectomy. Conclusion: HoLEP as the new gold standard treatment for surgical BPH therapy further. HoLEP remains its difficult learning curve when compared with traditional transurethral resection.
RESUMEN
Introduction: Transurethral resection ofthe prostate (TURP) has been considered asthe gold standard treatment for obstructivevoiding dysfunction in men with benignprostatic hyperplasia. This standard treatmenthas been challenged by consistent datademonstrating the superiority of Holmiumenucleation of the prostate (HoLEP). Wereview summarizes the literature comparingHoLEP to traditional therapies TURP, openprostatectomy (OP) for BPH these are widelyused and have long term efficacy data.Patients undergoing HoLEP have significantshortened catheterization times, decreasedlength of hospital stay, fewer serious postoperativecomplications, greater reduction inpost-operative IPSS, greater improvementsin post-operative Qmax and lower rates ofrepeat endoscopic procedures for recurrentsymptoms compared with TURP and OP.Furthermore, HoLEP can be used to resectmore than 100 grams tissue and it isequivalent efficacy to open prostatectomy.Conclusion: HoLEP as the new goldstandard treatment for surgical BPH therapyfurther. HoLEP remains its difficult learningcurve when compared with traditionaltransurethral resection.