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Background <p>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.</p> Purpose <p>To explore the effect of the ejaculatory preservation HoLEP technique on postoperative continence and ejaculation.</p> Patients and methods <p>We conducted a prospective randomized study adhering to CONSORT guidelines. Patients with prostate sizes between 40 and 80 gm, IPSS scores &gt; 20, Qmax &lt; 10 ml/s, and IIEF-5 scores  &gt; 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.</p> Results <p>Data from 40 patients were analyzed. Functional outcomes showed significant improvement in Group 1, with IPSS (median 12.5, P &lt; 0.006) and Qmax (median 15, P &lt; 0.04) at 3-month. ICIQ-UI SF scores showed a significant difference in the incontinence episodes (domain Q3), which were lower (P &lt; 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 &lt; 0.01 and P &lt; 0.02, respectively). IIEF-5 scores showed no significant difference between both groups during the study period.</p> Conclusion <p>Implementing the ejaculation preservation technique during HoLEP appears to improve early postoperative continence and preserve ejaculation.</p>

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Randomized prospective trial comparing ejaculatory preservation HoLEP versus standard HoLEP: the other face of the coin

  • 期刊论文

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  • 发表日期：

    2025年3月3日

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  • Ahmed Eliwa,
  • Ali Aldarraji,
  • Khaled Abdelwahab,
  • Emad Salem

摘要

Background

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.

Purpose

To explore the effect of the ejaculatory preservation HoLEP technique on postoperative continence and ejaculation.

Patients and methods

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.

Results

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.

Conclusion

Implementing the ejaculation preservation technique during HoLEP appears to improve early postoperative continence and preserve ejaculation.