Sexual Life Following &amp;lsquo;Minimal&amp;rsquo; and &amp;lsquo;Total&amp;rsquo; Transurethral Prostatic Resection

Møller-Nielsen, C; Lundhus, E; Möller‐Madsen, Bjarne; Nørgaard, J.B.; Simonsen, Ole; Hansen, Scott L.; Birkler, N. E.

doi:10.1159/000281022

Cited by 22 publications

(15 citation statements)

References 4 publications

(7 reference statements)

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“…The number of sexually active patients falls from 72 to 51 after surgery; in other words 70% of men sexually active prior to surgery remain sexually active. This figure is near to that given by Moller-Nielsen et al [8]. Bruskewitz et al [9] noticed a decreased or absent erection in a 1-year evaluation.…”

Section: Methodssupporting

confidence: 78%

Sexual Activity of Men Presenting with Prostatism: Effect of Prostatectomy

Vereecken¹

1989

Eur Urol

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Section: Methodssupporting

confidence: 78%

Sexual Activity of Men Presenting with Prostatism: Effect of Prostatectomy

Vereecken¹

1989

Eur Urol

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“…A trial comparing monopolar versus bipolar TURP did not show a difference in the rate of ejaculatory dysfunction although the study was likely not sufficiently powered to detect a difference (18). The volume of resection does not appear to impact the incidence of EjD (19). …”

Section: Effect Of Bph Treatments On Ejaculatory Functionmentioning

confidence: 93%

Ejaculatory dysfunction in the treatment of lower urinary tract symptoms

DeLay

Nutt

McVary

2016

Transl. Androl. Urol.

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The link between lower urinary tract symptoms (LUTS) secondary to benign prostatic hyperplasia (BPH) and sexual dysfunction is well established. Sexual dysfunction can encompass both ejaculatory dysfunction (EjD) and erectile dysfunction (ED). Ejaculatory dysfunction can consist of premature ejaculation, delayed ejaculation, retrograde ejaculation, anejaculation, decreased force of ejaculation and pain upon ejaculation. The impact of different medical and surgical therapies on ejaculatory function will be reviewed. We reviewed the various categories of LUTS treatment including the canonical epidemiology and pathophysiology as well as the surgical and medical treatments for LUTS/BPH. We note that most surgeries and several medical treatments have a certain but ill-defined negative impact on ejaculatory function. Several MISTs and selected medical therapies appear to have little impact on EjD. Both EjD and BPH are very common disorders in men under the care of an urologist. It is well documented that there is a clinical association between these two entities. Unfortunately many of the medical treatments and almost all surgical treatment impact the ejaculatory function of the patient. The surgical treatment of BPH often leads to retrograde ejaculation while medical treatment leads to anejaculation.

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“…We retrieved data for 3857 men randomized to 86 different study arms in 42 RCTs investigating BPH surgery and reporting EjD rates. Only one RCT assessed EjD as a primary outcome . Ten studies evaluated ejaculation before surgery identifying the incidence of new onset ejaculatory problems as well as the prevalence in men post‐BPH surgery .…”

Section: Evidence Synthesismentioning

confidence: 99%

Systematic review of lower urinary tract symptoms/benign prostatic hyperplasia surgical treatments on men's ejaculatory function: Time for a bespoke approach?

et al. 2015

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Although ejaculatory dysfunction is common for patients undergoing benign prostatic hyperplasia surgery, no clear evidence is present to counsel men seeking to preserve ejaculation. Our aim was to evaluate ejaculatory dysfunction in relation to benign prostatic hyperplasia surgery. We carried out a web and manual search using MEDLINE and Embase including randomized controlled trials reporting ejaculatory dysfunction after benign prostatic hyperplasia surgery: 42 randomized controlled trials comprising a total of 3857 patients were included. Only one study had ejaculatory dysfunction as a primary outcome, and just 10 evaluated ejaculatory dysfunction before and after surgery. The definition of ejaculatory dysfunction was not standardized. Similarly, just seven studies used internationally validated questionnaires to address ejaculatory dysfunction. The reported rates of ejaculatory dysfunction after resectional elecrosurgery, laser procedures, coagulation, ablation and implant techniques were assessed and compared. Transurethral resection of the prostate and recent laser procedures including holmium, thulium and GreenLight cause similar rates of ejaculatory dysfunction, occurring in almost three out of four to five men. Although providing less symptomatic benefit compared with transurethral resection of the prostate, transurethral incision of the prostate, transurethral needle ablation and transurethral microwave thermotherapy should be considered for men aiming to maintain normal ejaculation. UroLift is also a recent promising option for this category of patients. The vast majority of studies reporting ejaculatory dysfunction after benign prostatic hyperplasia surgery used poor methodology to investigate this complication. Future studies able to address clear hypothesis and considering ejaculatory dysfunction anatomical and pathophysiological features are required to develop ejaculation preserving techniques and to increase the evidence to counsel men aiming to preserve ejaculation.

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Sexual Life Following ‘Minimal’ and ‘Total’ Transurethral Prostatic Resection

Cited by 22 publications

References 4 publications

Sexual Activity of Men Presenting with Prostatism: Effect of Prostatectomy

Sexual Activity of Men Presenting with Prostatism: Effect of Prostatectomy

Ejaculatory dysfunction in the treatment of lower urinary tract symptoms

Systematic review of lower urinary tract symptoms/benign prostatic hyperplasia surgical treatments on men's ejaculatory function: Time for a bespoke approach?

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