Department of Urology, IRCCS Ospedale Casa Sollievo Della Sofferenza, San Giovanni Rotondo, Italy.
Department of Urology and Renal Transplantation, University of Foggia, Viale Luigi Pinto 1, 71122, Foggia, Italy.
World J Urol. 2024 Aug 16;42(1):486. doi: 10.1007/s00345-024-05127-6.
Prostatic urethral lift has been an effective ejaculation sparing treatment for benign prostatic hypertrophy. The aim of this study was to evaluate the effect on male semen parameters.
Between July 2014 and January 2022, 20 young men with urinary symptoms of BPH, unresponsive to drug treatment and motivated to preserve ejaculation for eventual paternity, underwent UroLift. Semen analysis was performed before and 6 month after surgery with evaluation of pH, volume, sperm concentration, total motility, vitality and morphology according to WHO 2011. All underwent digital rectal examination, transrectal prostate ultrasound to measure prostate volume, PSA, uroflowmetry, cystoscopy and urodynamics test if necessary. Objective and subjective urinary function was scheduled at 1, 3, 6, 12 month than yearly with UFM, IPSS, IIEF-5, and MSHQ-EjD-SF.
At a mean follow-up of 36 month (range 12 to 63), no retroejaculation or changes in seminal parameters occurred. Mean age was 44.5 (range 36.5 to 48) years. Mean operative time was 15 (range 10 to 20) min and 2.5 (range 2 to 4) implants per patients were used. At 6 month there were no difference in terms of total sperm count, volume, pH, motility, vitality, morphology, liquefaction, leucocytes (p = 0.9; p = 0.8; p = 0.7; p = 1; p = 1; p = 1; p = 0,2; p = 0.5). At last, Q-max increased by 64.4% (p = 0.001), post-void residual volume decreased by 66.6% (p = 0.016), and IPSS decreased by 60% (p < 0.001). IIEF and MSHQ-EjD-SF were preserved (p = 0.14, p = 0.4).
UroLift appears safe technique to correct LUTS from BPH in young men desirous to preserve seminal analysis.
前列腺尿道提升术已成为治疗良性前列腺增生症的一种有效的保留射精的治疗方法。本研究旨在评估其对男性精液参数的影响。
2014 年 7 月至 2022 年 1 月，20 名患有 BPH 症状的年轻男性，对药物治疗无反应，且有保留生育能力的意愿，接受了 UroLift 治疗。在手术前和手术后 6 个月进行精液分析，根据 2011 年世界卫生组织标准评估 pH 值、体积、精子浓度、总活力、活力和形态。所有患者均行直肠指检、经直肠前列腺超声测量前列腺体积、PSA、尿流率、膀胱镜检查和必要时行尿动力学检查。如果有必要，在 1、3、6、12 个月和每年进行客观和主观的尿功能评估，采用 UFM、IPSS、IIEF-5 和 MSHQ-EjD-SF 进行评估。
在平均 36 个月（12 至 63 个月）的随访中，没有发生逆行射精或精液参数变化。平均年龄为 44.5 岁（36.5 至 48 岁）。平均手术时间为 15 分钟（10 至 20 分钟），每个患者使用 2.5 个（2 至 4 个）植入物。在 6 个月时，总精子计数、体积、pH 值、活力、活力、形态、液化、白细胞无差异（p=0.9;p=0.8;p=0.7;p=1;p=1;p=1;p=0.2;p=0.5）。最后，Q-max 增加了 64.4%（p=0.001），残余尿量减少了 66.6%（p=0.016），IPSS 降低了 60%（p<0.001）。IIEF 和 MSHQ-EjD-SF 保持不变（p=0.14，p=0.4）。
UroLift 似乎是一种安全的技术，可以纠正有保留生育能力意愿的年轻男性的 BPH 引起的 LUTS。
