The clinical efficacy of sparing the proximal part of verumontanum for ejaculation preservation in holmium laser enucleation of the prostate

doi:10.3877/cma.j.issn.1674-3253.2018.05.009

Abstract

Abstract:

Objective

To explore the effectiveness of sparing the proximal part of verumontanum for ejaculation preservation in holmium laser enucleation of the prostate (HoLEP).

Methods

From May 2014 to May 2015, 40 sexually active patients with sufficient ejaculate underwent HoLEP. Twenty patients received ejaculation-preserving technique during HoLEP (EP-HoLEP group). The other 20 patients underwent conventional HoLEP (conventional-HoLEP group). In the EP-HoLEP group, the tissue >1 cm proximal to verumontanum was preserved.

Results

There was no significant difference in patient characteristics and perioperative parameters. Preoperatively, the volume of semen were (3.1±0.6) ml in HoLEP group and (3.4±0.7) ml in EP-HoLEP group (P>0.05); 12 months after surgery, there were (1.2±1.3) ml and (2.3±1.5) ml (P<0.05). Success rate of ejaculation preservation were 25% in HoLEP group and 60% in EP-HoLEP group, oppositely,the rate of retrograde ejaculation were 75% and 40% (P<0.05) respectively.

Conclusions

Sparing the proximal part of verumontanum in HoLEP could improve the success rate of ejaculation preservation.

Key words: Benign prostatic hyperplasia, Holmium laser, Enucleation of prostate, Retrograde ejaculation, Random, Prospective

Yang Wang, Qingping Han, Shuchen He, Haidan Li, Chunwei Ye, Zhipeng Li. The clinical efficacy of sparing the proximal part of verumontanum for ejaculation preservation in holmium laser enucleation of the prostate[J]. Chinese Journal of Endourology(Electronic Edition), 2018, 12(05): 327-331.

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References 22

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组别	例数	Q_max（ml/s）		PVR（ml）		IPSS(分)		QOL(分)		精液量（ml）
组别	例数	术前	术后12个月	术前	术后12个月	术前	术后12个月	术前	术后12个月	术前	术后12个月
HoLEP组	20	8.5±1.5	20.7±0.9^b	92.3±45.9	20±4^b	19.5±6.2	5.0±1.2^b	4.8±1.0	1.2±0.7^b	3.1±0.6	1.2±1.3^b
EP-HoLEP组	20	9.1±1.4	20.3±1.1^b	111.6±56.4	18±3^b	22.3±6.6	5.6±1.1^b	5.3±0.9	1.4±0.6^b	3.4±0.7	2.3±1.5^a

组别	例数	Q_max（ml/s）		PVR（ml）		IPSS(分)		QOL(分)		精液量（ml）
组别	例数	术前	术后12个月	术前	术后12个月	术前	术后12个月	术前	术后12个月	术前	术后12个月
HoLEP组	20	8.5±1.5	20.7±0.9^b	92.3±45.9	20±4^b	19.5±6.2	5.0±1.2^b	4.8±1.0	1.2±0.7^b	3.1±0.6	1.2±1.3^b
EP-HoLEP组	20	9.1±1.4	20.3±1.1^b	111.6±56.4	18±3^b	22.3±6.6	5.6±1.1^b	5.3±0.9	1.4±0.6^b	3.4±0.7	2.3±1.5^a

组别	例数	逆行射精例数	顺行射精例数
HoLEP组	20	15（75）	5（25）
EP-HoLEP组	20	8（40）	12（60）
P值	?	0.025

组别	例数	逆行射精例数	顺行射精例数
HoLEP组	20	15（75）	5（25）
EP-HoLEP组	20	8（40）	12（60）
P值	?	0.025

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