1975 LONG-TERM ERECTILE FUNCTION OUTCOMES AFTER HOLMIUM LASER ENUCLEATION OF THE PROSTATE (HOLEP)

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy and New Technology (I)1 Apr 20131975 LONG-TERM ERECTILE FUNCTION OUTCOMES AFTER HOLMIUM LASER ENUCLEATION OF THE PROSTATE (HOLEP) Andrea Salonia, Matteo Ferrari, Umberto Capitanio, Maria Chiara Clementi, Giulia Castagna, Paolo Capogrosso, Michele Colicchia, Eugenio Ventimiglia, Cesare Regina, Fabio Castiglione, Alberto Briganti, Rocco Damiano, Patrizio Rigatti, and Francesco Montorsi Andrea SaloniaAndrea Salonia Milan, Italy More articles by this author , Matteo FerrariMatteo Ferrari Milan, Italy More articles by this author , Umberto CapitanioUmberto Capitanio Milan, Italy More articles by this author , Maria Chiara ClementiMaria Chiara Clementi Milan, Italy More articles by this author , Giulia CastagnaGiulia Castagna Milan, Italy More articles by this author , Paolo CapogrossoPaolo Capogrosso Milan, Italy More articles by this author , Michele ColicchiaMichele Colicchia Milan, Italy More articles by this author , Eugenio VentimigliaEugenio Ventimiglia Milan, Italy More articles by this author , Cesare ReginaCesare Regina Milan, Italy More articles by this author , Fabio CastiglioneFabio Castiglione Milan, Italy More articles by this author , Alberto BrigantiAlberto Briganti Milan, Italy More articles by this author , Rocco DamianoRocco Damiano Catanzaro, Italy More articles by this author , Patrizio RigattiPatrizio Rigatti Milan, Italy More articles by this author , and Francesco MontorsiFrancesco Montorsi Milan, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2394AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To assess the rate of erectile function (EF) improvement at long-term follow-up (FU) in patients who underwent HoLEP for symptomatic obstructive benign prostatic hyperplasia (BPH). METHODS Complete sociodemographic, clinical and psychometric data from 135 patients submitted to HoLEP were analysed. All patients completed a remembered (=targeting sexual function regarding a period preceding HoLEP) International Index of Erectile Function-erectile function (IIEF-EF) domain; likewise, a real-time (=targeting the 4 weeks prior to surgery) IIEF (all domains) was filled. EF was stratified according to Cappelleri criteria. Both a remembered and a real-time International Prostate Symptom Score (IPSS) were also completed. Descriptive statistics and logistic regression models tested the association among potential clinical and surgical predictors and the eventual improvement of total IIEF-EF [also considering Minimal Clinically Important Differences (MCIDs) criteria]. RESULTS Mean (median) age at surgery was 63 (63.6) years (range: 49-82). Post-HoLEP FU was 152.1 (163.9) months (range: 12-324). At long-term FU, mean (SD) IPSS score significantly improved [15.9 (8.7) vs 5.4 (5.6); p<0.0001]. At long-term FU, IIEF domain scores were as follows: IIEF-EF: 19.2 (23); IIEF-SD: 6.3 (7); IIEF-OF: 4 (5); IIEF-IS: 8.0 (9); IIEF-OS: 6.6 (8). IIEF-EF significantly changed [mean delta -3.9 (-1)] as compared with the preoperative assessment with 23 (17%) patients reporting an improved IIEF-EF. Preoperative EF was normal EF, mild ED, mild-to-moderate ED, moderate ED, and severe ED in 83 (61.5%), 12 (9.0%), 16 (12%), 8 (6%), and 16 (12%) patients, respectively. Conversely, postoperative ED severity was normal EF, mild ED, mild-to-moderate ED, moderate ED, and severe ED in 42.2%, 15.6%, 10.4%, 5.2%, and 26.7% patients, respectively. Of all, 37% patients worsened of at least one IIEF-EF category; conversely, 55.6% and 7.4% patients maintained and eventually improved their IIEF-EF domain category, respectively. Nine (6.7%) patients showed a significant improvement according to MCIDs criteria. At MVA, both preoperative IPSS (OR: 1.12; p=0.002) and IIEF-EF (OR: 0.92; p=0.005) scores were significantly associated with postoperative improvement of IIEF-EF. CONCLUSIONS Long-term FU data showed that HoLEP significantly improved urinary symptoms in patients with symptomatic obstructive BPH, with a concomitant clinically significant EF improvement in roughly 7% of the individuals. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e810-e811 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrea Salonia Milan, Italy More articles by this author Matteo Ferrari Milan, Italy More articles by this author Umberto Capitanio Milan, Italy More articles by this author Maria Chiara Clementi Milan, Italy More articles by this author Giulia Castagna Milan, Italy More articles by this author Paolo Capogrosso Milan, Italy More articles by this author Michele Colicchia Milan, Italy More articles by this author Eugenio Ventimiglia Milan, Italy More articles by this author Cesare Regina Milan, Italy More articles by this author Fabio Castiglione Milan, Italy More articles by this author Alberto Briganti Milan, Italy More articles by this author Rocco Damiano Catanzaro, Italy More articles by this author Patrizio Rigatti Milan, Italy More articles by this author Francesco Montorsi Milan, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...