Urology Department, University Hospital of Tours, 2 boulevard Tonnellé, Tours, Loire Valley, France.
Eur Urol. 2010 Aug;58(2):207-11. doi: 10.1016/j.eururo.2010.04.027. Epub 2010 May 6.
Even though transurethral resection of the prostate remains the gold standard treatment for lower urinary tract symptoms (LUTS) refractory to medical therapy, photoselective vaporization of the prostate (PVP) has become a popular alternative. Early PVP studies seem encouraging, but few data exist regarding the effect of PVP on sexual function at long-term follow-up.
Our aim was to evaluate the impact of PVP on erectile function (EF) at long-term follow-up in men with LUTS due to benign prostatic hyperplasia (BPH).
DESIGN, SETTING, AND PARTICIPANTS: One hundred forty-nine consecutive patients who underwent a prostate vaporization with the GreenLight laser performed by a single surgeon (FB) were prospectively enrolled in this study.
All patients underwent PVP with the GreenLight laser performed by one experienced surgeon.
All patients were evaluated by International Index of Erectile Function (IIEF-5) preoperatively and at 1, 3, 6, and 12 mo and then once a year. At each visit, the questionnaires were collected, and each patient's maximum flow rate and postvoid residual volume were measured with ultrasound. Biologic data were also collected at each visit, including prostate-specific antigen, creatinine, and bacterial urine culture.
One hundred forty-nine patients were enrolled in the study. Median patient age was 74 yr. Urinary function was significantly improved over baseline in both men with normal or abnormal preoperative erectile function. Energy used was 255+/-129kJ. Hospitalization stay was 2.2+/-3.1 d. Other than a temporary difference at 1 yr, IIEF-5 scores were comparable preoperatively and postoperatively if we consider all the population. However, considering patients with preoperative IIEF-5 >19, the postoperative IIEF-5 scores were significantly decreased at 6, 12, and 24 mo.
Sexual function appears to be maintained after PVP; however, in patients with normal preoperative EF, we showed a significant decrease in EF after PVP.
尽管经尿道前列腺切除术仍然是治疗药物难治性下尿路症状（LUTS）的金标准，但前列腺激光汽化术（PVP）已成为一种流行的替代方法。早期的 PVP 研究似乎令人鼓舞，但关于 PVP 对长期随访时性功能影响的数据很少。
我们旨在评估经尿道前列腺汽化术（PVP）对良性前列腺增生（BPH）所致 LUTS 患者勃起功能（EF）的长期影响。
设计、设置和参与者：149 例连续患者前瞻性地接受了由一名经验丰富的外科医生（FB）进行的 GreenLight 激光前列腺汽化术。
所有患者均接受了由一位经验丰富的外科医生进行的 GreenLight 激光 PVP。
所有患者在术前、术后 1、3、6 和 12 个月以及每年进行一次国际勃起功能指数（IIEF-5）评估。每次就诊时，收集问卷，并使用超声测量每位患者的最大尿流率和残余尿量。每次就诊时还收集生物数据，包括前列腺特异性抗原、肌酐和尿液细菌培养。
本研究共纳入 149 例患者。中位患者年龄为 74 岁。无论术前勃起功能正常还是异常，男性的尿功能均较基线显著改善。使用的能量为 255+/-129kJ。住院时间为 2.2+/-3.1d。除了术后 1 年的暂时差异外，如果我们考虑所有人群，术前和术后的 IIEF-5 评分都是可比的。然而，如果考虑术前 IIEF-5>19 的患者，术后 6、12 和 24 个月时 IIEF-5 评分显著下降。
PVP 后性功能似乎得到维持；然而，在术前 EF 正常的患者中，我们发现 PVP 后 EF 显著下降。
