Faculty of Medicine, McGill University, Montreal, QC, Canada.
Division of Urology, Centre hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montreal, QC, Canada.
J Sex Med. 2020 Oct;17(10):2108-2112. doi: 10.1016/j.jsxm.2020.07.006. Epub 2020 Aug 6.
In the last decade, many novel minimally invasive surgical techniques within benign prostatic hyperplasia (BPH) surgery were developed to reduce postoperative complications that often discourage patients from pursuing BPH surgery.
To assess perspective of future and past international BPH surgery patients regarding their postoperative complications, namely erectile and ejaculatory function.
A survey was distributed randomly to 2 groups of BPH patients: one with 149 patients having undergone surgery in the last 2 years (group A), and the other cohort of 151 men seriously considering BPH surgery in the next year (group B). This survey consisted of 20 questions that assessed patients' motivating factors for undergoing elective BPH surgery and their perspectives regarding the potential postoperative complications attributed to BPH surgery.
The perspective of future and past international BPH surgical patients towards the preservation of their erectile and ejaculatory functions was assessed with the help of a survey.
Results indicated that in general BPH surgery patients considered the maintenance of erectile (95%, n = 284) and ejaculatory function (92%, n = 276) to be important preoperative considerations, regardless of their age. Patients aged 50-59 years were most concerned with the permanent impact on sexual function and patients aged >60 years were most concerned with urinary incontinence. In patients aged >70 years, 66% (n = 43) and 62% (n = 40) of the respondents indicated that maintaining erectile and ejaculatory function was important, respectively.
Patient-centered care needs to be implemented in order to address the importance that past and future BPH surgery patients hold toward the maintenance of their postoperative sexual function.
STRENGTHS & LIMITATIONS: In the group of patients having previously undergone BPH surgery, the possibility of recall bias should be taken into account when interpreting the study's findings. However, maintaining sexual function was also important for the group of patients seriously considering surgery in the next year suggesting that these considerations are not solely due to recall bias. Additionally, the results were limited by the small sample size of participants in groups A (n = 149) and B (n = 151).
It was found that past and future BPH surgery patients attribute a significant importance toward the maintenance of their sexual function. Although novel approaches with better sexual outcomes such as Rezum and UroLift for prostates <80 mL, and Aquablation for any size prostate are available, more research is needed to investigate their long-term effects on sexual function before they can be recommended to patients. Bouhadana D, Nguyen D-D, Zorn KC, et al. Patient Perspectives on Benign Prostatic Hyperplasia Surgery: A Focus on Sexual Health. J Sex Med 2020;17:2108-2112.
在过去的十年中，许多新的微创外科技术在良性前列腺增生（BPH）手术中得到了发展，以减少术后并发症，这些并发症常常使患者不愿接受 BPH 手术。
评估未来和过去的国际 BPH 手术患者对其术后并发症（即勃起和射精功能）的看法。
向两组 BPH 患者随机发放了一项调查：一组 149 例患者在过去 2 年内接受了手术（A 组），另一组 151 例患者严重考虑在明年接受 BPH 手术（B 组）。该调查包含 20 个问题，评估了患者接受择期 BPH 手术的动机因素，以及他们对归因于 BPH 手术的潜在术后并发症的看法。
通过调查评估了未来和过去的国际 BPH 手术患者对保留勃起和射精功能的看法。
结果表明，一般来说，BPH 手术患者认为维持勃起（95%，n=284）和射精功能（92%，n=276）是术前的重要考虑因素，无论他们的年龄如何。年龄在 50-59 岁的患者最关心性功能的永久性影响，年龄>60 岁的患者最关心尿失禁。年龄>70 岁的患者中，分别有 66%（n=43）和 62%（n=40）的受访者表示，维持勃起和射精功能很重要。
需要实施以患者为中心的护理，以满足过去和未来 BPH 手术患者对维持术后性功能的重视。
在接受过 BPH 手术的患者组中，在解释研究结果时应考虑到回忆偏倚的可能性。然而，对于严重考虑在下一年接受手术的患者组来说，维持性功能也很重要，这表明这些考虑不仅仅是由于回忆偏倚。此外，由于 A 组（n=149）和 B 组（n=151）参与者的样本量较小，结果也受到了限制。
研究发现，过去和未来的 BPH 手术患者都非常重视维持其性功能。虽然有一些新的方法，如 Rezum 和 UroLift 治疗前列腺体积<80ml，Aquablation 治疗任何大小的前列腺，具有更好的性功能结果，但在推荐给患者之前，还需要更多的研究来调查这些方法对性功能的长期影响。
