Ejaculatory dysfunction is the most common side effect of benign prostatic hyperplasia surgery. Modified techniques have emerged with the aim of preserving antegrade ejaculation without compromising obstruction relief. None are standardized or validated. The PARTURP study is a randomized study investigating partial versus complete prostate resection. We conducted an investigator consensus meeting to define the ideal surgical technique to achieve both correct obstruction relief with ejaculation preservation.
An expert consensus meeting involving all investigators of the PARTURP study took place to define a common technique using the nominal group methodology. The objectives were to define the areas to be resected and the areas to be preserved; to define the criteria for proper obstruction relief; to define the criteria for proper ejaculation preservation.
All investigators (n = 15) attended the consensus meeting, and agreement between all the participants was obtained. The anatomical landmarks to be preserved are located around the verumontanum and along the posterior part of the prostatic urethra. These structures must be preserved up to 2 cm from the verumontanum. The participants agreed on the need to preserve the urethral mucosa in all the areas to be preserved and to reach the enucleation plane in the areas of resection.
Anatomical landmarks for ejaculation-sparing surgery have been defined by the investigators of the PARTURP randomized study. These landmarks will be used during the study, and the clinical outcomes of this ejaculation-sparing technique will be compared with complete resection with up to 3 years follow-up.
World journal of urology. 2023 Sep 16 [Epub ahead of print]
Souhil Lebdai, Méric Ben Boujema, Antoine Benard, Nicolas Barry Delongchamps, Amine Benchikh, Franck Bruyere, Emmanuel Della Negra, Aurélien Descazeaud, Steeve Doizi, Marc Fourmarier, Richard Mallet, Vincent Misrai, Tiphaine Pelegrin, Yohan Rouscoff, Alain Ruffion, Arnaud Villers, Florence Saillour, Grégoire Robert
Urology Department, University Hospital of Angers, CHU Angers, 4 Rue Larrey, 49933, Angers Cedex 9, France. ., Methodology Department, University Hospital of Bordeaux, Bordeaux, France., Urology Department, Cochin Hospital, APHP, Paris Cité University, Paris, France., Urology Department, Clinique Des Franciscaines, Versailles, France., Urology Department, University Hospital of Tours, Tours, France., Urology Department, Hôpital Privé Des Côtes D'Armor, Plérin, France., Urology Department, University Hospital of Limoges, Limoges, France., Urology Department, Hôpital Tenon, APHP, Paris, France., Urology Department, CH Pays d'Aix, Aix en Provence, France., Urology Department, Hôpital Prive Francheville, Périgueux, France., Urology Department, Clinique Pasteur, Toulouse, France., Urology Department, Hôpital Henri Mondor, APHP, Paris, France., Urology Department, Polyclinique Saint Georges, Nice, France., Urology Department, University Hospital of Lyon, Lyon, France., Urology Department, University Hospital of Lille, Lille, France., Urology Department, University Hospital of Bordeaux, Bordeaux, France.