PD45-08 SELECTIVE MEDIAN LOBE LASER ENUCLEATION OF THE PROSTATE: PRESERVING SEXUAL FUNCTION WITHOUT COMPROMISING URINARY OUTCOMES

Abstract

You have accessJournal of UrologyCME1 May 2022PD45-08 SELECTIVE MEDIAN LOBE LASER ENUCLEATION OF THE PROSTATE: PRESERVING SEXUAL FUNCTION WITHOUT COMPROMISING URINARY OUTCOMES Benjamin Press, David Kim, Eric Ghiraldi, Michael Siev, and Daniel Kellner Benjamin PressBenjamin Press More articles by this author , David KimDavid Kim More articles by this author , Eric GhiraldiEric Ghiraldi More articles by this author , Michael SievMichael Siev More articles by this author , and Daniel KellnerDaniel Kellner More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002613.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Holmium laser enucleation of the prostate (HoLEP) is recommended for prostate glands of all sizes and is becoming a popular alternative to the transurethral resection of the prostate (TURP). Side effects of the procedure include stress incontinence, irritative lower urinary tract symptoms, and sexual function, most commonly retrograde ejaculation. We sought to evaluate perioperative outcomes related to sexual function and urinary function in patients who underwent selective laser enucleation of the prostate. METHODS: We conducted a retrospective review of the first 300 cases of HoLEP was performed from April 2019 – August 2021. Thirty-two patients within our cohort underwent selective enucleation of the median lobe of the prostate. Criteria for choosing to treat patients with selective enucleation were intravesical-prostatic protrusion or high bladder neck without obstructing lateral lobes. Patients were asked to comment on whether they had retrograde ejaculation during their follow up appointment. Urinary function was assessed using the American Urological Association Symptom Score (AUA-SS) and subjective evaluation of urinary incontinence. RESULTS: Mean age of our cohort was 65.9 years of age. Average peri-operative AUA-SS scores significantly improved (21.7 vs 6.8, p < 0.001). Average peri-operative quality of life scores significantly improved (4.1 vs 1.4, p < 0.001). Average peri-operative post void residual volumes were significantly improved (228.8 cc vs 45.7 cc, p = 0.001). No patients reported stress urinary incontinence. Of the 32 patients who underwent selective enucleation of the median lobe, 26 were sexually active. Of those men, 22 reported normal ejaculation, 2 men had retrograde ejaculation that was unchanged from pre-op. Data was missing for 2 men. CONCLUSIONS: In our case series of selective laser enucleation of the median lobe, urinary function significantly improved in short term follow-up with preservation of ejaculation in approximately 90% of men. A larger series is necessary with a longer follow up period to further investigate the durability of these findings. Further investigation is needed to define objective criteria to identify ideal candidates for selective median lobe enucleation. Source of Funding: None © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e785 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Benjamin Press More articles by this author David Kim More articles by this author Eric Ghiraldi More articles by this author Michael Siev More articles by this author Daniel Kellner More articles by this author Expand All Advertisement PDF DownloadLoading ...