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abstract

abstract

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Photoselective laser vaporization of the prostate: pronounced negative effect on the ejaculatory function

Sytenko, A1; Gorpynchenko, I1Vintoniv, O2

1: SI"Institute of urology of NAMSU", Ukraine; 2: Ivano-Frankivsk National medical university, urology, Ivano-Frankivsk, Ukraine

Objective: to assess changes in sexual function in sexually active (SA) men with BPH, who undergone photoselective laser vaporization of prostate (PLVP) due to bladder outlet obstruction (BOO).

Material and Methods: In 67 SA men with BPH (aged from 52 to 67) with BOO ( Qmax < 15ml/s) key sexual parameters (sexual desire (SD), erection, ejaculation, orgasm, intercourse attempts, satisfaction) were assessed at baseline (1-3 days before) and 1 (V1m) and 6 (V6m) month after PLVP by means of IIEF. Data are presented as Median (Pecentile 25; 75). Inter-grope differences assessed by Wilcoxon test. Significance level 0,05.

Results: At V1m and V6m sexual activity was resumed in 80,6% and 94,6% of men, respectively. Comparison of the baseline (V0) results of the IIEF questioning with those, obtained at V1m and V6m, indicated that operation did not effect SD intensiveness, erection and orgasm (data are not presented). Contrary, a high rate of ejaculatory dysfunction (EjD) Q9 (retrograde ejaculation) was revealed (Table 1). At V6m 71,4 % of men answered 1 - «never or almost never» on Q9. Statistically significant increase of SD frequency (presumably caused by irritation of the prostate) was registered at V1m but not at V6m. PLVP associated EjD did not result in changing of IIEF domains, characterized intercourse, sexual life, sexual relationship satisfaction (data are not presented).

Sexual parameters changed after PLVP                                                                         Table 1

Questions of IIEF

V0

V1m

P V0 - V1m

V6m

P V0 - V6m

Q6 intercourse attempts

2 (2;3)

1 (1;1)

<0,05

2 (2;3)

>0,05

Q9 ejaculation frequency

4 (3;5)

1 (1;2)

<0,05

1 (1;4)

<0,05

Q11 SD frequency  

3 (3;4)

4 (3;4)

<0,05

3 (3;4)

>0,05

Conclusions: PLVP dose not negatively influence erection, orgasm, libido in SA men with BPH, but associated with high rate of persistent (6 months after procedure) EjD (retrograde ejaculation).While shifting from pharmacotherapy to surgical procedures, SA men with BPH should be informed as to high risk of persistent EjD. Along with IPSS, IIEF should be adopted as a standard assessment tool in SA men with symptomatic BPH.

Disclosure:

Work supported by industry: no.

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