关键词: Benign prostatic hyperplasia Ejaculation preservation Ejaculatory dysfunction Endoscopic surgery Lower urinary tract symptoms Retrograde ejaculation

Mesh : Ablation Techniques Ejaculation Embolization, Therapeutic Endoscopy Humans Laser Therapy Lasers, Solid-State / therapeutic use Male Minimally Invasive Surgical Procedures Prostate / blood supply surgery Prostatic Hyperplasia / complications surgery therapy Prosthesis Implantation Sexual Dysfunction, Physiological / etiology prevention & control Steam Transurethral Resection of Prostate / adverse effects Urinary Bladder Neck Obstruction / etiology surgery therapy Urination Disorders / etiology prevention & control

来  源:   DOI:10.1007/s00345-018-2368-6

Abstract:
OBJECTIVE: Ejaculatory dysfunction is the most common side effect related to surgical treatment of benign prostatic obstruction (BPO). Nowadays, modified surgical techniques and non-ablative techniques have emerged with the aim of preserving antegrade ejaculation. Our objective was to conduce a systematic review of the literature regarding efficacy on ejaculatory preservation of modified endoscopic surgical techniques, and mini-invasive non-ablatives techniques for BPO management.
METHODS: A systematic review of the literature was carried out on the PubMed database using the following MESH terms: \"Prostatic Hyperplasia/surgery\" and \"Ejaculation\", in combination with the following keywords: \"ejaculation preservation\", \"photoselective vaporization of the prostate\", \"photoselective vapo-enucleation of the prostate\", \"holmium laser enucleation of the prostate\", \"thulium laser\", \"prostatic artery embolization\", \"urolift\", \"rezum\", and \"aquablation\".
RESULTS: The ejaculation preservation rate of modified-TURP ranged from 66 to 91%. The ejaculation preservation rate of modified-prostate photo-vaporization ranged from 87 to 96%. The only high level of evidence studies available compared prostatic urethral lift (PUL) and aquablation versus regular TURP in prospective randomized-controlled trials. The ejaculation preservation rate of either PUL or aquablation compared to regular TURP was 100 and 90 versus 34%, respectively.
CONCLUSIONS: Non-ablative therapies and modified endoscopic surgical techniques seemed to be reasonable options for patients eager to preserve their ejaculatory functions.
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