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Abstract：
The emergence of various endoscopic enucleation techniques in the past decade has provided surgeons with more options and opportunities in performing enucleation. With the same surgical principle as holmium laser enucleation of prostate, the early results of different techniques were comparable. However, sexual outcomes of endoscopic enucleation of the prostate (EEP) were less commonly reported than the voiding and urodynamic outcomes. In this review, the sexual outcomes including erectile function, ejaculatory and orgasmic function of various endoscopic enucleation technique would be studied. The overall sexual outcomes were heterogeneous and inconclusive. Outcomes measurement, sample size calculation, hypothesis generation and selection criteria were not specifically designed for sexual outcomes or even available. There were also limitations in the individual sexual assessment tools. Nonetheless, most studies showed no significant deterioration of erectile function after EEP, and ejaculation dysfunction was common. Looking forward in the field of benign prostatic enlargement surgery, the \'one size fits all\' notion should be abandoned. Treatment should be tailor-made according to the prostate size, co-morbidities and sexual needs. The sexual outcomes of enucleation have to be better studied and defined. More prospective controlled studies focusing primarily on sexual functions are needed. For enucleation surgeons, exploring different ejaculatory-sparing technique could be the golden opportunities in further consolidating the role and expanding the indication of enucleation surgery.
摘要：
在过去的十年中，各种内窥镜摘除术技术的出现为外科医生提供了更多的选择和机会。采用与钬激光前列腺摘除术相同的手术原理，不同技术的早期结果具有可比性。然而,与排尿和尿动力学结果相比,内镜下前列腺摘除术(EEP)的性结局报道较少.在这次审查中,性结果包括勃起功能，将研究各种内窥镜摘除技术的射精和高潮功能。总体性结果是异质的和不确定的。结果测量，样本量计算，假设产生和选择标准并非专门针对性结局而设计,甚至没有.个人性评估工具也存在局限性。尽管如此，大多数研究表明EEP后勃起功能没有明显恶化，射精功能障碍是常见的。展望良性前列腺扩大手术领域，“一刀切”的概念应该被放弃。治疗应根据前列腺大小量身定做，共病和性需求。必须更好地研究和定义摘除的性结果。需要更多的前瞻性对照研究，主要集中在性功能上。对于摘除外科医生来说，探索不同的射精保留技术可能是进一步巩固作用和扩大摘除手术适应证的绝佳机会.
