The protection of anterograde ejaculation function after transurethral enucleation of prostate by preserving the tissue between lateral lobe sulci of prostate

doi:10.3877/cma.j.issn.1674-3253.2024.05.006

Abstract

Abstract:

Objective

To compare the differences in the protection of postoperative ejaculatory function between transurethral plasma kinetic prostatectomy with preservation of 1 cm the tissue in front of colliculus seminalis (ejaculation-preserving technique) and the tissue between the lobular sulci (Cheng's ejaculation-preserving technique), the anatomical position of Cheng's ejaculation-preserving technique was made.

Methods

A retrospective analysis was performed on 27 patients with benign prostatic hyperplasia (BPH), aged (63±5) years, who had sexual activity and normal ejaculatory function and were admitted to the Second People's Hospital of Futian District from April 2021 to March 2023. BPH was treated by transurethral plasma kinetic prostate enucleation (Ep group) with ejaculation-preserving technique and transurethral plasma kinetic prostate enucleation (Cheng's group) with Cheng's ejaculation-preserving technique successfully by the same operator, including 14 cases in Ep group and 13 cases in Cheng's group. Preoperative and postoperative follow-up indexes of the two groups of patients were analyzed.

Results

The operations of all 27 patients was successfully completed. The follow-up time was (7.2±1.2) months. There were no significant differences in preoperative general data between the two groups, including age, prostate volume, international index of erectile function-5 (IIEF-5) and ejaculation status questionnaire, international prostate symptom score (IPSS), quality of life (QOL) score, maximum urine flow rate (Q_max) and residual urine volume (RUV) (P>0.05). During follow-up, IPSS, QOL, Q_max, RUV and IIEF-5 scores were not different significantly between the two groups before and after surgery (P>0.05). In Ep group, the anterograde ejaculation rate was 29% within 3 months and 7 months after operation. The incidence of anterograde ejaculation in Cheng's group was 92% within 3 months and 7 months after surgery.

Conclusion

During transurethral enucleation of the prostate, the preservation of the tissue between the lobular sulci of the prostate has a good effect on the protection of anterograde ejaculation function in short-term follow-up.

Key words: Ejaculation function, Benign prostatic hyperplasia, Enucleation of prostate

Zhigang Cheng, Hui Wei, Yibo Li, Jian Han, Yonghao Zhong, Ming Wang, Wenhui Zhang, Chuandong Zhou. The protection of anterograde ejaculation function after transurethral enucleation of prostate by preserving the tissue between lateral lobe sulci of prostate[J]. Chinese Journal of Endourology(Electronic Edition), 2024, 18(05): 453-458.

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References 27

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组别	例数	年龄(岁)	前列腺体积(ml)	残余尿量(ml)	最大尿流率(ml/s)	国际前列腺症状评分(分)	生活质量评分(分)	国际勃起功能指数	PSA(ng/ml)
Ep组	14	64±5	62±28	47±29	10.9±2.1	21.5±3.7	5.9±0.3	14.6±2.1	3.3±1.6
Cheng's组	13	61±5	53±14	37±21	11.6±1.6	22.3±3.8	5.8±0.4	15.5±2.9	3.1±1.4
t值		1.558	1.043	1.019	0.968	0.554	0.738	0.929	0.344
P值		0.132	0.307	0.318	0.342	0.584	0.467	0.362	0.733

组别	例数	年龄(岁)	前列腺体积(ml)	残余尿量(ml)	最大尿流率(ml/s)	国际前列腺症状评分(分)	生活质量评分(分)	国际勃起功能指数	PSA(ng/ml)
Ep组	14	64±5	62±28	47±29	10.9±2.1	21.5±3.7	5.9±0.3	14.6±2.1	3.3±1.6
Cheng's组	13	61±5	53±14	37±21	11.6±1.6	22.3±3.8	5.8±0.4	15.5±2.9	3.1±1.4
t值		1.558	1.043	1.019	0.968	0.554	0.738	0.929	0.344
P值		0.132	0.307	0.318	0.342	0.584	0.467	0.362	0.733

组别	例数	国际前列腺症状评分(分)	残余尿量(ml)	最大尿流率(ml/s)	生活质量评分(分)	国际勃起功能指数
Ep组	14	7.2±1.7	10±5	19.2±2.8	1.8±0.5	14.2±1.6
Cheng's组	13	6.8±1.1	10±4	20.5±3.1	1.7±0.6	15.6±2.6
t值		0.719	0.212	1.145	0.472	1.699
P值		0.479	0.834	0.263	0.641	0.102

组别	例数	国际前列腺症状评分(分)	残余尿量(ml)	最大尿流率(ml/s)	生活质量评分(分)	国际勃起功能指数
Ep组	14	7.2±1.7	10±5	19.2±2.8	1.8±0.5	14.2±1.6
Cheng's组	13	6.8±1.1	10±4	20.5±3.1	1.7±0.6	15.6±2.6
t值		0.719	0.212	1.145	0.472	1.699
P值		0.479	0.834	0.263	0.641	0.102

组别	例数	术后3个月		术后7个月
组别	例数	逆形射精	顺行射精	逆形射精	顺行射精
Ep组	14	10(71)	4(29)	10(71)	4(29)
Cheng's组	13	1(8)	12(92)	1(8)	12(92)
P值		<0.001		<0.001

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