Ejaculation-Sparing Anatomic Photoselective Enucleo-Vaporization Of The Prostate (Esa-Pvp): Early Results From A Single-Centre Prospective Cohort

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology IV (PD23)1 Sep 2021PD23-09 EJACULATION-SPARING ANATOMIC PHOTOSELECTIVE ENUCLEO-VAPORIZATION OF THE PROSTATE (ESA-PVP): EARLY RESULTS FROM A SINGLE-CENTRE PROSPECTIVE COHORT Paolo Destefanis, Mattia Sibona, Francesco Soria, Eugenia Vercelli, Federico Vitiello, Gabriele Montefusco, Andrea Bosio, Alessandro Bisconti, Beatrice Lillaz, and Paolo Gontero Paolo DestefanisPaolo Destefanis More articles by this author , Mattia SibonaMattia Sibona More articles by this author , Francesco SoriaFrancesco Soria More articles by this author , Eugenia VercelliEugenia Vercelli More articles by this author , Federico VitielloFederico Vitiello More articles by this author , Gabriele MontefuscoGabriele Montefusco More articles by this author , Andrea BosioAndrea Bosio More articles by this author , Alessandro BiscontiAlessandro Bisconti More articles by this author , Beatrice LillazBeatrice Lillaz More articles by this author , and Paolo GonteroPaolo Gontero More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002016.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ejaculatory Dysfunction (EjD) is common after traditional surgeries for Benign Prostatic Hyperplasia (BPH), causing significant bother to younger and sexually active patients. Recently, several endoscopic ejaculation-sparing techniques were described. In many cases, they represented an evolution of classic surgeries. Lasers appeared as particularly suitable for ejaculation-sparing surgery, due to great versatility. The aim of our study was to present the early results from a prospective cohort of patients undergoing an ejaculation-sparing anatomic photoselective enucleo-vaporization of the prostate (ESa-PVP) with 180W GreenLight laser. METHODS: Local ethical committee approval for our prospective observational protocol was obtained (CS2/667). We collected data from patients undergoing ESa-PVP at our Urology Department (Molinette Hospital, Torino School of Medicine) between November 2018 and June 2020. Sexually active, BPH patients requiring surgery for moderate to severe Lower Urinary Tract Symptoms (LUTS) were considered. Pre-operative and post-operative urinary and sexual functions were measured through internationally validated questionnaires (IPSS, IIEF5, MSHQ-EjD-SF). For all patients, we reported baseline and 6-months follow-up data. ESa-PVP was characterized by blunt posterior dissection of the adenoma with preservation of the “ejaculatory hood” and conservative approach to the bladder neck. RESULTS: 23 patients were included in our analysis. Median (IQR) age and prostate volume were 66 (60-72) years and 63 (52-90) cc. Median (IQR) energy delivered, laser time and total operative time were 210 (140-325) kiloJ, 21 (14-35) minutes and 55 (45-90) minutes. At baseline, median (IQR) questionnaire scores appeared as follows: IPSS 28 (24-30); IPSS bother score 4 (3-6); IIEF5 20 (16-25); MSHQ-EjD_SF 15 (9-15). At 6-months follow-up, median (IQR) questionnaire scores changed as follows: IPSS 1 (0-8), p<0.001; IPSS bother score 0 (0-2), p<0.001; IIEF5 19 (16-25), p=0.16; MSHQ-EjD-SF 8 (1-12), p<0.001. Globally, 14 out of 23 patients (60.87%) achieved antegrade ejaculation preservation. CONCLUSIONS: Early results from our cohort of ESa-PVP patients show optimal relief from LUTS, together with significant rates of antegrade ejaculation preservation. ESa-PVP could be considered as a therapeutic alternative for patients seeking for LUTS relief together with sexual function preservation. Further studies with larger sample size and longer follow-up will be needed. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e423-e424 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Paolo Destefanis More articles by this author Mattia Sibona More articles by this author Francesco Soria More articles by this author Eugenia Vercelli More articles by this author Federico Vitiello More articles by this author Gabriele Montefusco More articles by this author Andrea Bosio More articles by this author Alessandro Bisconti More articles by this author Beatrice Lillaz More articles by this author Paolo Gontero More articles by this author Expand All Advertisement Loading ...