A comparative study between traditional and ejaculation preserving Transurethral resection of prostate

Issam Al-Azzawi,Ihab Hussein

doi:10.33762/bsurg.2021.131298.1011

Abstract

This is to evaluate the efficacy & safety of a modified ejaculation preservation Transurethral Resection of Prostate ( epTURP ) , in comparison with the traditional technique - Transurethral Resection of Prostate ( TURP ) . A prospective controlled clinical interventional study whereby 40 Iraqi male patients scheduled for TURP were randomly assigned into 2 groups; group 1 treated with epTURP, and group 2 treated with TURP. Pre & post-operative evaluation of the patients included history taking, filling the international prostate symptom score ( IPSS ), the international index for erectile function ( IIEF – 15); questions 9,10,13 & 14, measurement of ejaculate volume, Uroflowmetry (Q-max) & measurement of Post Voiding Residual urine (PVR). Follow up schedule was at 6 weeks & 3 months post-operatively. The Mean age of patients was 59 year, mean prostate volume was 46 ml. Post-operatively 19/22 patients in the epTURP group & 3/18 patients in the TURP group had preserved their antegrade ejaculation, which led to a significant difference between the 2 groups in mean ejaculate volume & IIEF .There was a comparable improvement in post-operative values of IPSS, Q-max & PVR in both groups. Complications were minimal & manageable in both groups. In Conclusion The epTURP was in our experience a safe & effective technique in preserving antegrade ejaculation & improving urinary outflow in patients with prostate volume approaches 50 ml . Keywords: Transurethral resection of prostate, ejaculation preservation, uroflowmetry, post voiding residue, ejaculate volume

Highlights

Benign prostatic hyperplasia (BPH) is one of the most common urological diseases worldwide
Patients with symptomatic BPH are usually treated by medical therapies, which are effective in alleviating the Lower Urinary Tract Symptoms (LUTS) in most of the patients, with a low adverse effect profile, especially with the use of the currently available more selective alpha blockers 3
Patients & methods This is a prospective controlled clinical interventional study conducted through the period October 2017 to October 2019, whereby a group of Iraqi male patients complaining from LUTS due to BPH were included and treated by TURP

Summary

Introduction

Benign prostatic hyperplasia (BPH) is one of the most common urological diseases worldwide. Despite continuing development of minimally invasive surgical procedures for BPH, transurethral resection of the prostate (TURP) still remains the commonest surgical treatment for LUTS due to BPH, with the majority of patients reporting normal or improved voiding in long term follow-up [5,6]. Sexual function, including a normal antegrade ejaculation, is an important determinant of the QoL of male subjects. Losing this function after TURP, especially in relatively young patients ( in their fifties & sixties ), was always an issue of concern [11,12]. This study was conducted to evaluate the efficacy & safety of the modified ejaculation preservation technique of TURP ( epTURP ), regarding bladder outflow & preservation of antegrade ejaculation , in a group of Iraqi patients with BPH

Methods

Results

Conclusion