MP25-06 EJACULATION-PRESERVING VERSUS CONVENTIONAL TRANSURETHRAL RESECTION OF THE PROSTATE, A PROSPECTIVE RANDOMIZED STUDY

Abstract

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I (MP25)1 Apr 2020MP25-06 EJACULATION-PRESERVING VERSUS CONVENTIONAL TRANSURETHRAL RESECTION OF THE PROSTATE, A PROSPECTIVE RANDOMIZED STUDY Osama Abdelwahab*, Mohamed Habous, and Mohanad Aboanza Osama Abdelwahab*Osama Abdelwahab* More articles by this author , Mohamed HabousMohamed Habous More articles by this author , and Mohanad AboanzaMohanad Aboanza More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000864.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: One of the most common complications of transurethral resction of the prostate (TURP) is retrograde ejaculation . Trials to preserve ejaculation by modification of resection technique were done. however, the need of reoperation after doing ejaculation preservation techniques has been increased. In this study we compared ejaculation preservation TURP versus the standard TURP using Bipolar technology to evaluate the relative safety and efficacy of both techniques. METHODS: 97 patients with BPH were included in this study and randomized to operation by Olympus (Gyrus) Bipolar loop TURP into two groups (Group 1) 45 patients underwent conventional TURP and group 2 included 52 patient underwent ejaculation preservation technique by sparing 5 mm of prostatic urethra proximal to verumontanum. Inclusion criteria were; BPH with Qmax <10ml/sec, IPSS score>18 and prostate volume >40 gm. All patients were evaluated preoperatively and at 1, 3 and 9 months postoperatively by IPSS, uroflowmetry and prostate ultrasound. Clavien complications (including retrograde ejaculation) and operative time were recorded. RESULTS: There was no significant difference as regard age (51 + 9.9 and 52.5 + 8.2) , in both groups. Preoperative prostate volume (58 g v 55 g p=0.51) and IPSS (20 v 22 p=0.38) were equivalent. There was No Significant difference in operative time, postoperative prostate volume, and intraoperative blood loss (57± 15 minutes range 45-70 p 0.52) , versus (mean 59 ± 10 minutes range 35-75), (30±1 vs 29±2 g) p=0.31 , (0.6% compared to 0.7% drop in hemoglobin, p<0.55) . There was significant difference in Q max improvement Qmax (20 cc/s vs 14 cc/ s) (p <0.001), hospital stay (1-2 days in group 1 while 1-4 days in group 2) catheterization period (1-2 days versus 1-8 days) .Three patints in group 2 developed post operative urine retention refractory to conservative management and operated again by resection of residual prostatic tissues 3 weaks after 1st TURP. Postoperative IPSS was better in group one with significant difference in early postoperative period (6 versus 12) , p<0.001, however non significant difference at 6 and 12 month follow up (6 v 5, p=0.22) equivalently. Retrograde ejaculation occurred in 37 of 45 patients of group 1 while in 12 of 52 patients in group 2. Two patients in G2 received a second TURP due to the development of bladder neck obstruction at one year follow up. CONCLUSIONS: Antegrade ejaculation was preserved with the use of Ejaculation preservation TURP with excellent outcome however, the possible need for second TURP should be addressed with the patient as the improvement of urine flow is inferior to the conventional TURP. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e392-e393 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Osama Abdelwahab* More articles by this author Mohamed Habous More articles by this author Mohanad Aboanza More articles by this author Expand All Advertisement PDF downloadLoading ...