Gurlen Guclu, Aydamirov Mubariz, Vuruskan Ediz, Aksay Bugra, Karkin Kadir
Department of Urology, Ministry of Health, Adana City Training and Research Hospital, Adana, Turkey.
Department of Urology, Baskent University Alanya Application and Research Center, Antalya, Turkey.
Ir J Med Sci. 2025 Feb;194(1):385-389. doi: 10.1007/s11845-024-03854-8. Epub 2024 Dec 12.
Studies evaluating lower urinary tract symptoms (LUTS) and sexual functions after holmium laser enucleation of prostate (HoLEP) are very limited.
To evaluate both the LUTS voiding and storage functions of patients after HoLEP operation and to examine its effect on postoperative sexual functions.
The data of male patients who underwent HoLEP for benign prostatic hyperplasia (BPH) between May 2019 and February 2022 were evaluated. The International Prostate Symptom Index (IPSS) was used for questioning LUTS. The International Erectile Function Index-Erectile Function (IIEF-EF) section was completed to evaluate erectile functions and Male Sexual Health Questionnaire-Ejaculation function (MSHQ-EjD) was completed to evaluate ejaculation functions.
A total of 427 patients were included in the study. A significant improvement was found in IPSS total, storage, and voiding scores at the 3rd month follow-ups of the patients after HoLEP. While improvement was detected in the erectile functions of the patients (p < 0.001), a significant decrease was found in MSHQ-EjD scores (15.97 ± 2.26 vs. 11.02 ± 3.69; p = 0.002). More than 50% reduction in IPSS scores was found in 85.48% (365/427) of the patients. It was determined that the patients who did not benefit from the treatment had higher preoperative IPSS-storage symptoms (p = 0.001), lower IIEF-EF scores (p < 0.001), and higher PVRs (p = 0.001).
HoLEP is an effective method that can be used safely and effectively in the treatment of LUTS due to BPH. While both storage and voiding functions of the patients improve, there is no worsening in erectile functions, but deterioration in ejaculation functions can be observed.
评估钬激光前列腺剜除术（HoLEP）后下尿路症状（LUTS）和性功能的研究非常有限。
评估HoLEP手术后患者的LUTS排尿和储尿功能，并检查其对术后性功能的影响。
评估2019年5月至2022年2月期间因良性前列腺增生（BPH）接受HoLEP手术的男性患者的数据。使用国际前列腺症状指数（IPSS）询问LUTS。完成国际勃起功能指数-勃起功能（IIEF-EF）部分以评估勃起功能，并完成男性性健康问卷-射精功能（MSHQ-EjD）以评估射精功能。
本研究共纳入427例患者。在HoLEP术后患者的第3个月随访中，IPSS总分、储尿和排尿评分均有显著改善。虽然患者的勃起功能有所改善（p<0.001），但MSHQ-EjD评分显著降低（15.97±2.26 vs. 11.02±3.69；p=0.002）。85.48%（365/427）的患者IPSS评分降低超过50%。确定未从治疗中获益的患者术前IPSS储尿症状更高（p=0.001），IIEF-EF评分更低（p<0.001），残余尿量更高（p=0.001）。
HoLEP是一种可安全有效地用于治疗BPH所致LUTS的有效方法。患者的储尿和排尿功能均有改善，勃起功能无恶化，但射精功能可观察到恶化。
