State of copulative function in patients after the holmium laser enuсleation of benign prostatic hyperplasia

Popov, Sergey V.; Валерьевич, Попов Сергей; Орлов, И.Н.; Николаевич, Орлов Игорь; Grin, Yevgeniy A.; Александрович, Гринь Евгений; Демидов, Д. А.; Александрович, Демидов Дмитрий; Gulko, A.M.; Михайлович, Гулько Александр; Sushina, I V; Викторовна, Сушина Ирина; Malevich, S M; Михайлович, Малевич Сергей; Vyazovtsev, P.V.; Вячеславович, Вязовцев Павел

doi:10.17816/uroved9217-22

Cited by 3 publications

(2 citation statements)

References 19 publications

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“…Попова и соавт. [28] выявлено разнонаправленное влияние ТУЛЭП гольмиевым лазером (HoLEP) на копулятивную функцию больных ДГПЖ. Под наблюдением находились 79 пациентов с ДГПЖ, у всех до операции были выявлены проявления копулятивной дисфункции.…”

Section: оригинальные статьиunclassified

“…Сходные тенденции были отмечены и другими исследовательскими группами [29][30][31]. Большинство авторов указывают, что независимо от метода трансуретрального вмешательства, включая и лазерные операции, у значительного числа больных в послеоперационном периоде наблюдается ретроградная энуклеация, частота которой варьирует от 30 до 97 % [28][29][30][31]. Вероятной причиной ее возникновения считают повреждение мышечных волокон шейки мочевого пузыря.…”

Section: оригинальные статьиunclassified

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Assessment of copulative function and severity of lower urinary tract symptoms in patients with benign prostatic hyperplasia after transurethral enucleation

Vydrin

Kalinina

Burlaka

et al. 2021

Urology reports (St. - Petersburg)

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AIM: was to conduct a comparative assessment of copulative function and the severity of lower urinary tract symptoms (LUTS) in patients with benign prostatic hyperplasia (BPH) who underwent laser and bipolar transurethral enucleation of the prostate and who treated conservatively. MATERIALS AND METHODS: 143 BPH patients aged 50 to 80 years (mean age 65 years) with complaints of copulatory and urinary disorders were under observation. All patients were divided into two groups. The 1st (main) group included 102 patients who underwent surgical treatment: transurethral laser enucleation of the prostate (n = 55) and transurethral bipolar enucleation of the prostate (n = 47). Patients of the 2nd group (n = 41) received conservative treatment. Control examinations were performed before treatment, 4, 12 and 24 weeks after it. RESULTS: All 102 patients of group 1, regardless of the type of surgery, noted retrograde ejaculation four weeks after surgery. In the majority of patients of the 1st group during these periods weakening of orgasm was noted, in a significant number deterioration of erection and decreased libido were noted. Upon further observation, by the 12th week after the operation, restoration of all components of the copulatory function was noted, with the exception of ejaculation. By the 24th week of observation, only in 2 patients of the 1st group the normal mechanism of ejaculation was restored. Surgical treatment of patients in group 1, regardless of the method of surgery, led to a significant decrease in the severity of LUTS, an increase in the maximum urine flow rate, a decrease in the volume of the prostate gland and the amount of residual urine. There were no significant differences in the dynamics of these indicators depending on the method of transurethral enucleation. The patients of the 2nd group also had an improvement in clinical parameters, but it was much less pronounced than in the 1st group. CONCLUSION: Laser and bipolar transurethral enucleation of the prostate are effective surgical techniques that significantly improve the outflow of urine from the bladder, reduce the severity of LUTS and improve the sexual function of patients. Surgery is well tolerated by patients. At the same time, almost all patients operated on by these methods develop retrograde ejaculation.

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Section: оригинальные статьиunclassified

Assessment of copulative function and severity of lower urinary tract symptoms in patients with benign prostatic hyperplasia after transurethral enucleation

Vydrin

Kalinina

Burlaka

et al. 2021

Urology reports (St. - Petersburg)

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Comparing the clinical efficacy of prostate enucleation by the Millin method and enucleation performed using a holmium laser (HoLEP) with a prostate volume more than 80 cm3

Volkov,

Stepanchenko,

Tereshchenko

et al. 2024

Issled. prakt. med. (Print)

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Purpose of the study was to compare of the average long-term results of classical prostate enucleation using the Millin method and enucleation performed using a holmium laser (HoLEP). Patients and methods. This study, conducted on the basis of the Endocrinology Research Center of the Ministry of Health of the Russian Federation, included 100 patients operated on for obstruction of the prostatic part of the urethra over the period 2020–2023. The main indication for surgery was benign prostatic hyperplasia. The selection criterion for patients was a prostate volume of more than 80 cm3. The patients were divided into 2 groups depending on the intervention performed: in the 1st group Millin surgery was performed (n = 50), in group 2n laser enucleation of the prostate was done (n = 50). The data obtained during the operation in the early postoperative period, as well as the results of postoperative follow-up of patients were analyzed. Results. In the mid-term period, 4–6 months after surgery, patients from both groups were observed to improve their condition and reduce complaints of dysuric phenomena. The results were obtained illustrating a shorter inpatient stay for patients who underwent HoLEP (4.3 ± 0.6 days versus 10.0 ± 2.4 during Millin surgery), which is correspondingly associated with a faster recovery after this intervention compared with the classic one. A statistically significant (p-value < 0.05) problem of patients from the HoLEP group was urethral stricture, which occurred in 6 % of the subjects from this group and did not occur in the Millin surgery group. In fact, scarring of the bladder neck was more commonly obserbed (10 % vs. 8 %) in the Millin surgery group. However, these complications were not more than 10 %. As a result of the study, there was no statistically significant effect of using HoLEP on erectile dysfunction in patients, which suggests the potential of this technique for a lower incidence of worsening erectile dysfunction compared with open intervention. Conclusions. HoLEP is a safe method of prostate enucleation, applicable for its large volume, in particular, up to 80 cm3. This procedure is an alternative to classical open surgery, and can be recommended for patients with polymorbidity to reduce the risk of perioperative complications and reduce rehabilitation time. Millin surgery is also a reliable treatment method with high sensitivity to the detection of cellular atypia and a large volume of cytoreduction. The decision on the surgical procedure used must be made individually for each patient.

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Results of ultrasound dopplerography of the penis in patients with before and after transurethral enucleation of benign prostatic hyperplasia

Vydrin

Kalinina

Кореньков

2021

Urology reports (St. - Petersburg)

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BACKGROUND: The development of modern technologies for the surgical treatment of urological diseases poses new questions for urologists. One of them is to evaluate the effect of transurethral enucleation of benign prostatic hyperplasia on the erectile function of patients. AIM: The aim of the study was to assess the state of erectile function in patients before and after transurethral enucleation of benign prostatic hyperplasia using Doppler ultrasound of the vessels of the penis. MATERIALS AND METHODS: The study included 102 patients with benign prostatic hyperplasia aged 50 to 80 years (average 65 years) with complaints of erectile dysfunction and urinary disorders. All patients underwent transurethral enucleation of benign prostatic hyperplasia: 55 patients with the laser method (HoLEP, group 1) and 47 patients with the bipolar method (TUEB, group 2). The severity of ED was assessed using the IIEF-5 questionnaire (International Index of Erectile Function). To assess the state of blood flow in the penis, ultrasound dopplerography of the vessels of the penis was performed using a vasoactive erection stimulator. The studies were carried out before surgery and 24 weeks after it. RESULTS: The results of ultrasound dopplerography of the vessels of the penis before surgery revealed the arteriogenic type of ED in 18 (17.6%) patients, the venous type in 45 (44.2%) patients, the mixed arteriovenogenic type in 22 (21.6%) patients. In 17 (16.7%) patients ED was regarded as psychogenic. 24 weeks after the operation in patients of both the 1st and 2nd groups, according to the data of the IIEF-5 questionnaire, positive dynamics of the severity of erectile function was noted, regardless of the type of ED. For patients with vasculogenic types of ED, similar trends were noted regardless of the type of surgery. Thus, in patients with arteriogenic and arteriovenogenic ED a significant increase in the maximum systolic blood flow velocity (Vmax) in the cavernous arteries was recorded, while the values of the resistance index (RI) did not change significantly. At the same time, the Vmax values in these patients were initially low before the operation, and after the operation did not reach the reference values. In patients with venogenic ED, there was no significant improvement in penile blood flow, as evidenced by the absence of significant differences in Vmax and RI values. At the same time, the RI in these patients before the operation was reduced, and the Vmax values were in the range of normal values. CONCLUSIONS: The erectile function of patients after transurethral enucleation of benign prostatic hyperplasia improves regardless of the type of operation and the type of erectile dysfunction. Ultrasound dopplerography of the vessels of the penis is a minimally invasive and highly informative diagnostic method that makes it possible to detect circulatory disorders in the penis and assess its state in dynamics during treatment.

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State of copulative function in patients after the holmium laser enuсleation of benign prostatic hyperplasia

Cited by 3 publications

References 19 publications

Assessment of copulative function and severity of lower urinary tract symptoms in patients with benign prostatic hyperplasia after transurethral enucleation

Assessment of copulative function and severity of lower urinary tract symptoms in patients with benign prostatic hyperplasia after transurethral enucleation

Comparing the clinical efficacy of prostate enucleation by the Millin method and enucleation performed using a holmium laser (HoLEP) with a prostate volume more than 80 cm3

Results of ultrasound dopplerography of the penis in patients with before and after transurethral enucleation of benign prostatic hyperplasia

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