背景：Thulium激光（Tm：YAG）前列腺手术是一种安全有效的手术，发病率低，临床结果与经尿道前列腺电切术（TURP）相当。然而,性功能结果（勃起和射精功能）几乎没有研究。
目的：我们旨在评估Tm:YAG前列腺手术对性结局（勃起和射精功能）的影响，并与接受TURP的患者进行比较。
方法：我们搜索了像PUBMED这样的数字数据库，Scopus,CENTRAL和EMBASE使用相关关键词来确定TURP的比较研究和Tm：YAG前列腺手术的非比较研究，以评估性结果。我们对提取的数据进行了定性和定量分析。我们进行了一项荟萃分析，以比较接受Tm：YAG或TURP的患者术后国际勃起功能指数（IIEF-5）评分和逆行射精（RE）的发生率。合并术前和术后IIEF-5评分以估计总分。
结果：我们纳入了5项比较研究和8项非比较研究。我们发现，Tm：YAG前列腺手术组术后IIEF-5评分改善明显高于TURP组，平均差异（MD）为0.45（95％CI，0.18至0.72；P=.001）。我们发现这些程序之间没有显著的关联。RE关联的合并OR估计为0.90（95％CI，0.50至1.60；P=.71；I2=0％）。
结论：Tm：YAG前列腺手术比TURP更能改善勃起功能，根据我们的发现。Tm:YAG前列腺辅助手术在手术后保留性功能方面也优于TURP。然而,我们发现Tm：YAG前列腺手术和TURP之间的RE发生率相似或没有差异。BiboL,郝L,庞K,etal.对接受thulium激光前列腺手术治疗良性前列腺增生患者的性结局进行评估：系统评价和荟萃分析。SexMed2022；10：100483。
BACKGROUND: Thulium laser (Tm:YAG) prostate surgery is a safe and effective procedure with low morbidity and comparable clinical outcomes to those of transurethral resection of the prostate (TURP). However, the sexual function outcomes (erectile and ejaculatory function) have been scarcely studied.
OBJECTIVE: We aimed to assess the impact of Tm:YAG prostate surgery on sexual outcomes (erectile and ejaculatory function) and compare them with those patients undergoing TURP.
METHODS: We searched digital databases like PUBMED, SCOPUS, CENTRAL and EMBASE using relevant keywords to identify comparative studies on TURP and non-comparative studies on Tm:YAG prostate surgery that assessed sexual outcomes. We performed qualitative and quantitative analyses with the extracted data. We carried out a meta-analysis to compare postoperative International Index of Erectile Function (IIEF-5) scores and incidences of retrograde ejaculation (RE) in patients undergoing either Tm:YAG or TURP. The pre-operative and post-operative IIEF-5 scores were pooled to estimate overall scores.
RESULTS: We included 5 comparative and 8 non-comparative studies in this review. We found the postoperative IIEF-5 score improvements to be significantly higher in the Tm:YAG prostate surgery group than in the TURP group with a significant mean difference (MD) of 0.45 (95% CI, 0.18 to 0.72; P = .001). We found no significant associations between the procedures. The pooled OR for the association of RE was estimated at 0.90 (95% CI, 0.50 to 1.60; P = .71; I2 = 0%).
CONCLUSIONS: Tm:YAG prostate surgery improves erectile function more than TURP, according to our findings. Tm:YAG prostate aided surgery also outperforms TURP in terms of preserving sexual function following surgery.However, We found similar or no difference in incidence of RE between Tm:YAG prostate surgery and TURP. Bibo L, Hao L, Pang K, et al. Assessment of Sexual Outcomes in Patients Undergoing Thulium Laser Prostate Surgery for Management of Benign Prostate Hyperplasia: A Systematic Review and Meta-analysis. Sex Med 2022;10:100483.
