Impact on Sexual Function of Holmium Laser Enucleation Versus Transurethral Resection of the Prostate: Results of a Prospective, 2-Center, Randomized Trial

Briganti, Alberto; Naspro, Richard; Gallina, Andrea; Salonia, Andrea; Vavassori, Ivano; Hurle, Rodolfo; Scattoni, Enzo; Rigatti, Patrìzio; Montorsi, Francesco

doi:10.1016/s0022-5347(05)00983-3

Cited by 160 publications

(140 citation statements)

References 19 publications

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“…Table 5 shows the most important English language papers of interest. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Use of validated questionnaires is essential in sexual function assessment. Soderdhal et al 16 showed that a nonvalidated questionnaire may cause false reports of ED.…”

Section: Discussionmentioning

confidence: 99%

Effect of transurethral resection of the prostate on erectile function: a prospective comparative study

et al. 2009

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The effect of transurethral resection of the prostate (TURP) on erectile function is still controversial, and available evidence is conflicting. One of the possible mechanisms of post-TURP erectile dysfunction (ED) is direct thermal injury to the erectile nerves. The aim of this study was to investigate the effect of TURP on erectile function. Fifty patients undergoing TURP for obstructive benign prostatic hyperplasia (HBP) were prospectively included in the study, and 50 age-matched patients undergoing transurethral resection of the superficial bladder tumor were also prospectively included as a control group. All patients completed the international index of erectile function (IIEF-15), the international prostatic symptom score (IPSS) and the Hospital Anxiety and Depression Scale at inclusion in the study and then at the 3-and 6-month follow-up evaluation. Capsular perforations during TURP were prospectively reported by the operating surgeon. There was a significant improvement of erectile function in the TURP group despite the onset of ejaculation disorders in 70% of the patients. Improvement of erectile function was also found in the subgroup of patients with capsular perforation during TURP. Comparison with the control group showed that at preoperative evaluation, patients in the TURP group had more severe urinary symptoms and worse erectile function than did those of the control group. At the postoperative period, the IPSS score became comparable in the two groups, with major improvement of erectile function in the TURP group. We concluded that TURP improved erectile function in HBP patients with severe urinary symptoms. This improvement of erectile function was observed even in case of capsular perforation.

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Section: Discussionmentioning

confidence: 99%

Effect of transurethral resection of the prostate on erectile function: a prospective comparative study

et al. 2009

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“…[61][62][63] In a randomized comparison of TURP with holmium laser enucleating of the prostate, holmium laser enucleating of the prostate was not associated with worsening erectile function after surgery and there was no difference compared with TURP. 64 A number of studies related to Greenlight laser vaporization of the prostate describe no influence [65][66][67] or even improvement 68 of erectile function. In contrary to the previously mentioned studies, in another study in a group of preoperatively potent patients (IIEF-5418), a significant negative impact on erectile function following the Greenlight procedure was observed.…”

Section: Luts and Ed: Effects On Clinical Managementmentioning

confidence: 99%

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

2011

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There is strong evidence from multiple epidemological studies that lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) are correlated, independent of age or comorbidities as diabetes or hypertension. Although a direct causal relationship is not established yet, four pathophysio logical mechanisms can explain the relationship. These include alteration in nitric oxide bioavailability, a1-adrenergic receptor hyperactivity, pelvic atherosclerosis and sex hormones. This association has different clinical implications on the management of both disorders. Men seeking care for one condition should always be screened for complaints of the other condition. Sexual function should be assessed and discussed with the patient when choosing the appropriate management strategy for LUTS, as well as when evaluating the patient's response to treatment. Multiple large clinical trials have shown an improvement in LUTS after phosphodiesterase-5 (PDE5)-inhibitor treatment. PDE5 inhibitors show promise as a future treatment for LUTS, either in conjunction with existing therapies or as a primary treatment. There may be a potential therapeutic role for testosterone in LUTS treatment in cases of testosterone deficiency that needs to be investigated. Much further investigation is required, but it is evident that the association between LUTS and ED is fundamental for future therapies and possible preventative strategies.

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“…There were no significant differences in late complication rates of ure-thral strictures, bladder neck contractures, or need for reoperation. In a comparison of the impact of each surgical technique on erectile function, both HoLEP and TURP equally lowered responses on the orgasmic domain of the International Index of Erectile Function questionnaire [25].…”

Section: Many Comparative Trials Of the Holep Technique Versusmentioning

confidence: 94%

Current Laser Therapies for the Treatment of Benign Prostatic Hyperplasia

2016

IJSR

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Abstract:The gold standard for symptomatic relief of bladder outlet obstruction secondary to be-nign prostatic hyperplasia has traditionally been a transurethral resection of the pros-tate (TURP). Over the past decade, however, novel laser technologies that are patient friendly as compared to the con-ventional TURP have been developed. As part of the ongoing quest to minimize complica-tions, shorten hospitalization, improve resection time, and most importantly reduce mortality, laser prostatectomy has continually evolved. Today, there are more varia-tions of laser prostatectomy, each with several differing surgical techniques. Although abundant data are available confirming the safety and feasibility of the various laser systems, future randomized-controlled trials will be necessary to verify which techni-que is superior. In this article, we describe the most common modalities used to perform a laser prostatectomy, mainly, the holmium laser and the potassium-titanyl-phosphate lasers. We also highlight the physical and clinical characteristics of each technology with a review of their efficacy.

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Impact on Sexual Function of Holmium Laser Enucleation Versus Transurethral Resection of the Prostate: Results of a Prospective, 2-Center, Randomized Trial

Abstract: TURP and HoLEP significantly lowered the IIEF orgasmic function domain with no differences between techniques. This was caused by retrograde ejaculation. Marginal, nonsignificant erectile function improvement was reported after surgery in the 2 groups.

Cited by 160 publications

References 19 publications

Effect of transurethral resection of the prostate on erectile function: a prospective comparative study

Effect of transurethral resection of the prostate on erectile function: a prospective comparative study

Association of lower urinary tract symptoms and erectile dysfunction: pathophysiological aspects and implications for clinical management

Current Laser Therapies for the Treatment of Benign Prostatic Hyperplasia

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