%0 Journal Article
%T Modified holmium laser enucleation for benign prostatic obstruction to preserve sexual and ejaculatory function.
%A Long Depaquit T
%A Baboudjian M
%A Chiron P
%A Corral R
%A Anastay V
%A Bastide C
%A Toledano H
%J Fr J Urol
%V 34
%N 2
%D 2024 Mar
%M 38717462
暂无%R 10.1016/j.fjurol.2024.102581
%X <B>BACKGROUND: </B>To report ejaculatory and urinary results in patients who underwent holmium laser enucleation of the prostate (HoLEP) with selective laser enucleation of the median lobe (MLHoLEP).<BR><B>METHODS: </B>Patients with lower urinary tract symptoms (LUTS)/benign prostatic obstruction (BPO) who underwent MLHoLEP to preserve ejaculatory function in a single center were retrospectively identified. Urinary function was assessed using International Prostate Score Symptom (IPSS), IPSS-Quality of Life index (IPSS-QoL), peak urinary flow (Qmax) and postvoid residual (PVR). Erectile function was assessed using International Index of Erectile Function (IIEF-5). In patients with preoperative antegrade ejaculation, retrograde ejaculation was routinely screened at each follow-up visit. Sexual and urinary functions at 3 and 12 months were compared with baseline values.<BR><B>RESULTS: </B>A total of 55 patients met our inclusion criteria. A significant improvement in the IPSS, IPSS-QoL, PVR and Qmax was found at 3 and 12 months, compared with baseline (all P<0.05). Eight patients (14.5%) required surgical reintervention due to persistant LUTS/BPO. No significant changes in the erectile function were found at 3 (P=0.3) and 12 months (P>0.9). In patients with preoperative antegrade ejaculation (n=32), only four cases of de novo retrograde ejaculation were recorded postoperatively.<BR><B>CONCLUSIONS: </B>MLHoLEP represents a new alternative for men with LUTS/BPO who wish to preserve their ejaculatory function. Patients should be aware that improvement in urinary function may be inferior to the traditional technique, with a higher reintervention rate due to persistent LUTS.<BR><B>METHODS: </B>Grade 4.