alta uro AG, Basel, Switzerland; University Basel, Basel, Switzerland.
Hospital de S. João, Porto, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal.
Eur Urol Focus. 2018 Jan;4(1):43-45. doi: 10.1016/j.euf.2018.05.001. Epub 2018 May 24.
Transurethral resection of the prostate as well as laser prostatectomy (by either holmium laser enucleation of the prostate or Greenlight laser vaporization) is associated with risks of sexual dysfunction such as antegrade ejaculation and occasionally erectile dysfunction. While ejaculation-sparing variations of these techniques show promising results, larger multicenter studies are needed to confirm promising data. Prostatic urethral lift maintains erectile and ejaculatory function at 5-yr follow-up. The same is true for the 3-yr data on the Rezum system. Recently, Aquablation has shown promising results; however, these 6-mo data need to be confirmed during longer follow-up. An individualized, shared decision-making process based on clinical parameters and patient preference is warranted to select the ideal treatment option for each patient.
Sexual dysfunction such as loss of ejaculation and, less frequently, erectile dysfunction can occur after transurethral prostate surgery. Ejaculation-sparing modifications as well as minimally invasive alternatives show promising results. An individualized approach is warranted to select the ideal technique for each patient.
经尿道前列腺切除术以及激光前列腺切除术（包括钬激光前列腺剜除术或绿激光汽化术）与性功能障碍相关，如逆行射精，偶尔还会出现勃起功能障碍。尽管这些技术的射精保存改良方法显示出良好的效果，但仍需要更大规模的多中心研究来证实这些有前途的数据。前列腺尿道提升术在 5 年随访时可维持勃起和射精功能。 Rezum 系统的 3 年数据也是如此。最近，Aquablation 显示出良好的效果；然而，这些 6 个月的数据需要在更长的随访中得到证实。应根据临床参数和患者偏好进行个体化、共同决策过程，为每位患者选择理想的治疗方案。
经尿道前列腺手术后可能会出现性功能障碍，如射精丧失，且较少见的情况下还会出现勃起功能障碍。射精保存改良方法以及微创替代方法显示出良好的效果。应采用个体化方法为每位患者选择理想的技术。
