Department of Urology, Weill Cornell Medical College-New York Presbyterian, New York, New York.
Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York.
J Endourol. 2020 Mar;34(3):322-329. doi: 10.1089/end.2019.0558.
After transurethral prostatectomy, erectile dysfunction and ejaculatory dysfunction are significant concerns for patients. We compared ejaculatory hood-sparing technique in patients who underwent photoselective vaporization of the prostate using the GreenLight Laser (EjS-PVP) with the ejaculatory hood-sparing technique in patients who underwent bipolar button plasma vaporization of the prostate (EjS-BPVP) in the surgical management of benign prostatic hyperplasia (BPH). Twenty-seven patients were randomized to either undergo EjS-PVP or EjS-BPVP from August 2016 to March 2018. All of the patients were sexually active with antegrade ejaculation before prostatectomy. We evaluated International Prostate Symptom Score (IPSS), quality of life (QoL), peak flow rate (Qmax), postvoid residual volume (PVR), International Index of Erectile Function and ejaculatory function by the Male Sexual Health Questionnaire (MSHQ). Men were evaluated preoperatively and at 1, 3, and 6 months postoperatively. The primary outcome was ejaculation preservation measured as no change or preservation in antegrade ejaculate at the last follow-up visit by MSHQ (6 months). Twenty-seven patients with a mean age of 65.6 ± 8.4 years underwent either EjS-BPVP or EjS-PVP (Table 1). There were no differences in baseline characteristics between the two groups. Improvements in IPSS, QoL, Qmax, and PVR were durable throughout the study period in both groups. There was no difference in outcomes between groups. Postoperatively, there was no change in ejaculatory function with EjS-BPVP utilizing either 180 W EjS-PVP or bipolar energy. The change in MSHQ Ejaculation Scale was -2.1 and -5.4 at 6 months in both arms. The 6-month ejaculatory preservation rate was 85% in the EjS-PVP group and 78% in the EjS-BPVP group. EjS GreenLight photoselective vaporization and bipolar plasma button vaporization is a safe and effective method for treating men with lower urinary tract symptoms secondary to BPH with maintenance of antegrade ejaculation.
经尿道前列腺切除术（TURP）后，勃起功能障碍和射精功能障碍是患者的主要关注点。我们比较了绿激光前列腺选择性汽化术（PVP）中应用射精罩保留技术（EjS-PVP）和双极按钮等离子汽化术（BPVP）中应用射精罩保留技术（EjS-BPVP）治疗良性前列腺增生（BPH）的疗效。2016 年 8 月至 2018 年 3 月，27 例患者被随机分为 EjS-PVP 组或 EjS-BPVP 组。所有患者前列腺切除术前均有正向射精，且有活跃的性生活。我们通过国际前列腺症状评分（IPSS）、生活质量（QoL）、最大尿流率（Qmax）、剩余尿量（PVR）、国际勃起功能指数（IIEF）和男性性健康问卷（MSHQ）的射精功能评估评估了患者的情况。患者术前及术后 1、3 和 6 个月进行评估。主要结局是通过 MSHQ（6 个月）评估的射精保留情况，即末次随访时无逆行射精或保留正向射精。27 例患者平均年龄 65.6±8.4 岁，分别接受了 EjS-BPVP 或 EjS-PVP（表 1）。两组患者的基线特征无差异。两组的 IPSS、QoL、Qmax 和 PVR 均在研究期间持续改善。两组间结果无差异。术后，无论是使用 180 W EjS-PVP 还是双极能量，EjS-BPVP 对射精功能均无影响。两组在 6 个月时 MSHQ 射精量表评分分别改变了-2.1 和-5.4。6 个月时 EjS-PVP 组和 EjS-BPVP 组的射精保留率分别为 85%和 78%。GreenLight 前列腺选择性汽化术和双极等离子按钮汽化术是治疗因 BPH 而下尿路症状的男性的安全有效的方法，可保留正向射精。
