Sri Ramachandra Institute of Higher Education and Research, Chennai, India.
World J Urol. 2024 Oct 8;42(1):567. doi: 10.1007/s00345-024-05276-8.
Benign prostatic hyperplasia (BPH) is a common urological condition, particularly among middle-aged and elderly men. Trans urethral resection of prostate (TURP) has some drawbacks, particularly concerning ejaculatory function. Ejaculation preserving TURP (Ep-TURP) is one such technique that aims at preserving the tissues that are primarily responsible for antegrade ejaculation.
In this prospective study, patients with bothersome LUTS were randomized into Ep-TURP and standard TURP groups. Supramontal tissue was preserved in Ep-TURP while standard TURP group had resection of the entire prostatic tissue up to the verumontanum. The outcomes with regard to IPSS, Qmax, IIEF(Q9), Ejaculation and PVR were studied. Ejaculation projection score was separately calculated and assessed.
About 60 patients were studied, with 30 in each group. At 6 months' follow-up, complication rates were the same in both groups. The IPSS, Qmax, IIEF were similar and comparable. There was no change in erection in all patients (P = 0.559). The ejaculation was well preserved in Ep-TURP (p<0.001). Ejaculation projection score was maintained at 3.77 in the Ep-TURP group while in the standard group it was 0 (P<0.001).
Ep-TURP is a safe and a cost-effective method of preserving ejaculation in patients undergoing TURP. This procedure adds a better quality of life that greatly aids in enhancing the improving his psychological outlook towards life. Ep-TURP has now emerged as the standard procedure of choice in sexually active young males needing TURP, as the degree of ejaculation is largely well preserved in patients undergoing this procedure.
良性前列腺增生（BPH）是一种常见的泌尿科疾病，尤其常见于中年和老年男性。经尿道前列腺切除术（TURP）有一些缺点，特别是在射精功能方面。保留射精功能的 TURP（Ep-TURP）是一种旨在保留主要负责顺行射精的组织的技术。
在这项前瞻性研究中，有排尿困难症状的患者被随机分为 Ep-TURP 和标准 TURP 组。Ep-TURP 中保留了鞍上组织，而标准 TURP 组切除了整个前列腺组织直至精阜。研究了 IPSS、Qmax、IIEF（Q9）、射精和 PVR 的结果。分别计算和评估了射精投影评分。
大约 60 名患者接受了研究，每组 30 名。在 6 个月的随访中，两组的并发症发生率相同。IPSS、Qmax、IIEF 相似且可比较。所有患者的勃起均无变化（P=0.559）。Ep-TURP 中射精得到很好的保留（p<0.001）。Ep-TURP 组的射精投影评分维持在 3.77，而标准组为 0（p<0.001）。
Ep-TURP 是一种安全且具有成本效益的方法，可在接受 TURP 的患者中保留射精。该手术增加了更好的生活质量，极大地有助于改善患者的心理生活前景。Ep-TURP 现在已成为需要 TURP 的年轻活跃男性的标准手术选择，因为接受该手术的患者的射精程度在很大程度上得到了很好的保留。
