Laser Anatomical Endoscopic Enucleation of the Prostate (LAEEP) techniques offer a promising solution for patients seeking to alleviate urinary symptoms while preserving sexual function. The ejaculation preservation approach has been shown to achieve an impressive 90% success rate in maintaining antegrade ejaculation.
To explore the effect of the ejaculatory preservation HoLEP technique on postoperative continence and ejaculation.
We conducted a prospective randomized study adhering to CONSORT guidelines. Patients with prostate sizes between 40 and 80 gm, IPSS scores > 20, Qmax < 10 ml/s, and IIEF-5 scores > 22 were eligible for inclusion. A total of 43 patients were randomized into two groups: Group 1 (n = 22) underwent HoLEP, while Group 2 (n = 21) underwent EP HoLEP. We assessed functional outcomes and ejaculatory dysfunction at baseline and 1-, 3-, and 6- month. The study period was from October 2022 to March 2024.
Data from 40 patients were analyzed. Functional outcomes showed significant improvement in Group 1, with IPSS (median 12.5, P < 0.006) and Qmax (median 15, P < 0.04) at 3-month. ICIQ-UI SF scores showed a significant difference in the incontinence episodes (domain Q3), which were lower (P < 0.023) in Group 2 compared to Group 1 during the 1-month visit. MSHQ-EjD-SF scores were significantly higher in Group 2 at both 3- and 6- month (P < 0.01 and P < 0.02, respectively). IIEF-5 scores showed no significant difference between both groups during the study period.
Implementing the ejaculation preservation technique during HoLEP appears to improve early postoperative continence and preserve ejaculation.
World journal of urology. 2025 Mar 03*** epublish ***
Ahmed Eliwa, Ali Aldarraji, Khaled Abdelwahab, Emad Salem
Department of Urology, Zagazig University Hospitals, Zagazig, Egypt., Department of Urology, Zagazig University Hospitals, Zagazig, Egypt. .