Ejaculatory-protective transurethral resection of the prostate


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Development of retrograde ejaculation is observed in the majority of patients who underwent standard transurethral resection of the prostate (TURP). One of the main causes of this state has always been a damage of the bladder neck during surgery. At the same time, preserving the intact the area around the seminal crest during TURP allows to protect the natural ejaculatory mechanisms. From May to December 2010, 42 patients with infravesicular obstruction caused by benign prostatic hyperplasia (study group) underwent adopted original method of ejaculatory-protective TURP (EP TURP). The control group consisted of 40 patients who underwent standard TURP. Exclusion criteria included: history of surgery on the pelvic organs, the presence of urethral stricture, diabetes mellitus, neurological disease, and erectile dysfunction. Patients in both groups were matched by age, prostate volume, I-PSS and QoL indices, peak flow rate and residual urine volume. The performance of intraoperative and immediate postoperative period, as well as long-term results 12, 24 and 36 months after surgery were evaluated. The mean duration of surgery in the study group was 44.5 ± 19.5 min, in control group - 32.9 ± 16.1 min. In the study group, 32.8 ± 8.4 g of tissue was removed, in the control group - 58.2 ± 6.3 g. In both groups, the positive results achieved by surgery have remained stable for 3 years. Serious intra- and postoperative complications in any of the groups were not recorded. Ejaculatory-protective surgery has allowed to fully preserve the natural ejaculation in 48.7% of patients, and partially - in 25.6% versus 14.3 and 8.6% of patients who underwent the standard method of surgery. The ejaculatory-protective TURP is an effective and safe method of surgical treatment of patients with benign prostatic hyperplasia, wishing to maintain antegrade ejaculation.

Full Text

Restricted Access

About the authors

A. G Martov

MRI FMBA; RMAPE; SBHCI «CCH № 57 of Moscow Healthcare Department»

Email: maitovalex@maiI.ru
MD, Professor, Head of Department of Urology MRI FMBA, Professor at the Department of endoscopic urology RMAPE, Head of Department of Urology CCH № 57 of Moscow Healthcare Department

A. S Andronov

MRI FMBA; SBHCI «CCH № 57 of Moscow Healthcare Department»

S. V Dutov

SBHCI «CCH № 57 of Moscow Healthcare Department»

N. A Baykov

RMAPE; SBHCI «CCH № 57 of Moscow Healthcare Department»

References

  1. De la Rosette J., Alivizatos G., Madersbacher S. et al. Guidelines on benign prostatic hyperplasia. EAU Guidelines, edition presented at the 25th EAU Annual Congress, Barcelona 2010, 2008.
  2. Rassweiler J., Teber D., Kuntz R. et al. Complications of transurethral resection of the prostate (TURP) - Incidence, management, and prevention. Eur. Urol. 2006; 50: 969-979.
  3. Reich O., Gratzke C., Bachmann A. et al. Morbidity, mortality and early outcome of transurethral resection of the prostate: A prospective multicenter evaluation of 10,654 patients. J Urol. 2008; 180: 246-249.
  4. Gallizia P. The smooth sphincter of the vesical neck, a genital organ. Urol. Int. 1972; 27: 341.
  5. Marberger H. The mechanisms of ejaculation. Basic Life Sci. 1974; 4: 99-110.
  6. Hedlund H., Ek A. Ejaculation and sexual function after endoscopic bladder neck incision. Br. J Urol. 1985; 57: 164-167.
  7. Yang S.S., Tsai Y.C., Chen J.J. et al. Modified transurethral incision of the bladder neck treating primary bladder neck obstruction in young men: A method to improve voiding function and to preserve antegrade ejaculation. Urol. Int. 2008; 80: 26-30.
  8. Ruzic B., Trnski D., Kraus O. et al. New modification of transurethral incision of the prostate in surgical treatment of bladder outlet obstruction: Prospective study. Croat Med J. 2002; 43: 610-614.
  9. Hermabessiere J., Guy L., Boiteux J.P. Human ejaculation: Physiology, surgical conservation of ejaculation. Prog Urol. 1999; 9: 305-309.
  10. Gil-Vernet J.M., Jr., Alvarez-Vijande R., Gil-Vernet A. et al. Ejaculation in men: A dynamic endorectal ultrasonographical study. Br. J Urol. 1994; 73: 442-448.
  11. Rosen R.C., Riley A., Wagner G. et al. The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology. 1997; 49: 822-830.
  12. Lang C., Eichel R., Alloussi S.H. et al. Ejaculation preserving technique in endourological treatment of BPH, (ep)-Laservaporesection and epTUR of the prostate. Germany: EAU, 2009.
  13. Abdel-Basir Sayed M. Bladder neck resection with preservation of antegrade ejaculation: Basir technique. J Endourol. 2003; 17: 109-111.
  14. Ronzoni G., De Vecchis M. Preservation of anterograde ejaculation after transurethral resection of both the prostate and bladder neck. Br. J Urol. 1998; 81: 830-833.
  15. Мартов А.Г., Лопаткин Н.А. Руководство по трансуретральной эндоскопической электрохирургии доброкачественной гиперплазии простаты. Триада Х, 1997. С. 72-91.
  16. Kaplan S.A. Side effects of alpha-blocker use: retrograde ejaculation. Rev. Urol. 2009; 11: S14-S18.
  17. Alloussi S.H., Lang C., Eichel R. et al. Ejaculation-Preserving Transurethral Resection of Prostate and Bladder Neck: Short- and Long-term Results of a New Innovative Resection Technique. J Endourol. 2013 Oct 10. [Epub ahead of print]. DOI: 10.1089/ end.2013.0093D0I: 10.1089/end.2013.0093.
  18. Del Rosso A., Masciovecchio S., Saldutto P. et al. TURP in the young man: is it possible to preserve the anterograde ejaculation? Urologia. 2013; 80(1): 64-69.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies