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Longitudinal changes in erectile function after thulium:YAG prostatectomy for the treatment of benign prostatic obstruction: a 1-year follow-up study

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Abstract

This study aimed to evaluate the impact of thulium:yttrium-aluminum-garnet (Tm:YAG) (RevoLix®) laser prostatectomy for the treatment of benign prostatic obstructions on erectile function (EF). A total of 208 patients who underwent Tm:YAG laser prostatectomies participated in this study. All cases were evaluated preoperatively and at 3, 6, and 12 months postoperatively using the International Prostate Symptom Score (IPSS), quality of life (QoL) score, and the International Index of Erectile Function (IIEF-5) questionnaires. Patients were divided into groups A (severe erectile dysfunction [ED]), B (moderate ED), and C (mild-to-normal ED), according to their IIEF-5 scores. The median patient ages were 69, 65, and 62 years in groups A, B, and C, respectively. Significant improvements occurred in the IPSS and QoL score within the groups during the 12-month follow-up period. The IIEF-5 scores at 3 months postoperatively were lower than the preoperative scores in groups B and C. The IIEF-5 scores subsequently improved during the 12-month follow-up period. The slope of the relationship between the IIEF-5 score and the time since Tm:YAG laser prostatectomy had a ß value of 0.2210 (95% confidence interval 0.103 to 0.338, p = 0.0003); hence, each postoperative month was associated with an increase of 0.2210 in the IIEF-5 score. The IIEF-5 scores gradually increased and reached the preoperative levels by the 12-month follow-up assessment. Although the IIEF-5 score dropped significantly during the first 3 months postoperatively, it improved over the following 12 months. Tm:YAG laser prostatectomy did not impact on EF ultimately.

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References

  1. Kassabian VS (2003) Sexual function in patients treated for benign prostatic hyperplasia. Lancet 361:60–62

    Article  PubMed  Google Scholar 

  2. Berry SJ, Coffey DS, Walsh PC et al (1984) The development of human benign prostatic hyperplasia with age. J Urol 132:474–479

    Article  CAS  PubMed  Google Scholar 

  3. Zong HT, Peng XX, Yang CC et al (2012) The impact of transurethral procedures for benign prostate hyperplasia on male sexual function: a meta-analysis. J Androl 33:427–434

    Article  PubMed  Google Scholar 

  4. Frieben RW, Lin HC, Hinh PP et al (2010) The impact of minimally invasive surgeries for the treatment of symptomatic benign prostatic hyperplasia on male sexual function: a systematic review. Asian J Androl 12:500–508

    Article  PubMed  PubMed Central  Google Scholar 

  5. Martin DJ, Mulhall JP (2005) Enlarging the scope of managing benign prostatic hyperplasia: addressing sexual function and quality of life. Int J Clin Pract 59:579–590

    Article  CAS  PubMed  Google Scholar 

  6. Xia SJ, Zhuo J, Sun XW et al (2008) Thulium laser versus standard transurethral resection of the prostate: a randomized prospective trial. Eur Urol 53:382–389

    Article  PubMed  Google Scholar 

  7. Szlauer R, Götschl R, Razmaria A et al (2009) Endoscopic vaporesection of the prostate using the continuous-wave 2-microm thulium laser: outcome and demonstration of the surgical technique. Eur Urol 55:368–375

    Article  PubMed  Google Scholar 

  8. Bach T, Wendt-Nordahl G, Michel MS et al (2009) Feasibility and efficacy of thulium:YAG laser enucleation (VapoEnucleation) of the prostate. World J Urol 27:541–545

    Article  CAS  PubMed  Google Scholar 

  9. Bach T, Herrmann TR, Haecker A et al (2009) Thulium:yttrium-aluminium-garnet laser prostatectomy in men with refractory urinary retention. BJU Int 104:361–364

    Article  PubMed  Google Scholar 

  10. Gross AJ, Netsch C, Knipper S et al (2013) Complications and early postoperative outcome in 1080 patients after thulium vapoenucleation of the prostate: results at a single institution. Eur Urol 63:859–867

    Article  PubMed  Google Scholar 

  11. Ahn TY, Lee DS, Kang WC et al (2001) Validation of an abridged Korean version of the international index of erectile function (IIEF-5) as a diagnostic tool for erectile dysfunction. Korean J Urol 42:535–540

    Google Scholar 

  12. Chung JS, Kang PM, Seo WI et al (2014) Thulium laser (RevoLix) vaporesection versus vapoenucleation with morcellator (Piranha) for the treatment of benign prostatic obstruction: a propensity-matched multicenter analysis. Int J Urol 21:1156–1161

    Article  PubMed  Google Scholar 

  13. Tscholl R, Largo M, Poppinghaus E et al (1995) Incidence of erectile impotence secondary to transurethral resection of benign prostatic hyperplasia, assessed by preoperative and postoperative snap gauge tests. J Urol 153:1491–1493

    Article  CAS  PubMed  Google Scholar 

  14. Muntener M, Aellig S, Kuettel R et al (2007) Sexual function after transurethral resection of the prostate (TURP): results of an independent prospective multicentre assessment of outcome. Eur Urol 52:510–515

    Article  PubMed  Google Scholar 

  15. Mamoulakis C, Skolarikos A, Schulze M et al (2013) Bipolar vs monopolar transurethral resection of the prostate: evaluation of the impact on overall sexual function in an international randomized controlled trial setting. BJU Int 112:109–120

    Article  PubMed  Google Scholar 

  16. Paick JS, Um JM, Kim SW et al (2007) Influence of high-power potassium-titanyl-phosphate photoselective vaporization of the prostate on erectile function: a short-term follow-up study. J Sex Med 4:1701–1707

    Article  PubMed  Google Scholar 

  17. Bruyère F, Puichaud A, Pereira H et al (2010) Influence of photoselective vaporization of the prostate on sexual function: results of a prospective analysis of 149 patients with long-term follow-up. Eur Urol 58:207–211

    Article  PubMed  Google Scholar 

  18. Bouchier-Hayes DM, Van Appledorn S, Bugeja P et al (2010) A randomized trial of photoselective vaporization of the prostate using the 80-W potassium-titanyl-phosphate laser vs transurethral prostatectomy, with a 1-year follow-up. BJU Int 105:964–969

    Article  PubMed  Google Scholar 

  19. Briganti A, Naspro R, Gallina A et al (2006) Impact on sexual function of holmium laser enucleation versus transurethral resection of the prostate: results of a prospective, 2-center, randomized trial. J Urol 175:1817–1821

    Article  PubMed  Google Scholar 

  20. Jeong MS, Ha SB, Lee CJ et al (2012) Serial changes in sexual function following holmium laser enucleation of the prostate: a short-term follow-up study. Korean J Urol 53:104–108

    Article  PubMed  PubMed Central  Google Scholar 

  21. Klett DE, Tyson MD 2nd, Mmeje CO et al (2014) Patient-reported sexual outcomes after holmium laser enucleation of the prostate: a 3-year follow-up study. Urology 84:421–426

    Article  PubMed  Google Scholar 

  22. Tiburtius C, Knipper S, Gross AJ et al (2014) Impact of thulium VapoEnucleation of the prostate on erectile function: a prospective analysis of 72 patients at 12-month follow-up. Urology 83:175–180

    Article  PubMed  Google Scholar 

  23. Wang Y, Shao J, Lu Y et al (2014) Impact of 120-W 2-μm continuous wave laser vapoenucleation of the prostate on sexual function. Lasers Med Sci 29:689–693

    Article  PubMed  Google Scholar 

  24. Yee CL, Pal RP, Batchelder A et al (2012) Risk of erectile dysfunction and retrograde ejaculation associated with thulium laser vaporesection of the prostate for bladder outflow obstruction: a retrospective study. Urol Int 88:165–169

    Article  PubMed  Google Scholar 

  25. Elshal AM, Elmansy HM, Elkoushy MA et al (2012) Male sexual function outcome after three laser prostate surgical techniques: a single center perspective. Urology 80:1098–1104

    Article  PubMed  Google Scholar 

  26. Lynch MJ (2010) Transurethral resection of the prostate stands accused of causing impotence in patients: should it be found culpable? BJU Int 106:614–619

    Article  PubMed  Google Scholar 

  27. Martinez-Jabaloyas JM, Gil-Salom M, Villamon-Fort R et al (2001) Prognostic factors for response to sildenafil in patients with erectile dysfunction. Eur Urol 40:641–646

    Article  CAS  PubMed  Google Scholar 

  28. Jaidane M, Arfa NB, Hmida W et al (2010) Effect of transurethral resection of the prostate on erectile function: a prospective comparative study. Int J Impot Res 22:146–151

    Article  CAS  PubMed  Google Scholar 

  29. Hamann MF, Naumann CM, Seif C et al (2008) Functional outcome following photoselective vaporisation of the prostate (PVP): urodynamic findings within 12 months follow-up. Eur Urol 54:902–907

    Article  PubMed  Google Scholar 

  30. Kavoussi PK, Hermans MR (2008) Maintenance of erectile function after photoselective vaporization of the prostate for obstructive benign prostatic hyperplasia. J Sex Med 5:2669–2671

    Article  PubMed  Google Scholar 

  31. Hossack TA, Woo HH (2012) Sexual function outcome following photoselective vaporisation of the prostate. Int Urol Nephrol 44:359–364

    Article  PubMed  Google Scholar 

  32. Meng F, Gao B, Fu Q et al (2007) Change of sexual function in patients before and after Ho:YAG laser enucleation of the prostate. J Androl 28:259–261

    Article  PubMed  Google Scholar 

  33. Kim SH, Yang HK, Lee HE et al (2014) HoLEP does not affect the overall sexual function of BPH patients: a prospective study. Asian J Androl 16:873–877

    Article  PubMed  PubMed Central  Google Scholar 

  34. Bach T, Muschter R, Sroka R et al (2012) Laser treatment of benign prostatic obstruction: basics and physical differences. Eur Urol 61:317–325

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported by a grant from the Inje University 2011 research fund (No. 2011-0760), South Korea.

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Correspondence to Jae II Chung.

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We obtained approval from the institutional review boards at Haeunde Paik Hospital and Busan Paik Hospital.

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The authors declare that they have no conflict of interest.

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Chung, J.S., Park, S.H., Oh, C.K. et al. Longitudinal changes in erectile function after thulium:YAG prostatectomy for the treatment of benign prostatic obstruction: a 1-year follow-up study. Lasers Med Sci 32, 1517–1523 (2017). https://doi.org/10.1007/s10103-017-2273-z

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  • DOI: https://doi.org/10.1007/s10103-017-2273-z

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