A randomized prospective study of the efficacy of ejaculation- preserving bipolar transurethral resection of prostate

Abdulmoaty, Mohamed Hasanain; Elhawy, Mamdouh Abdelhameed; Tawfik, Ehab Refaat; Abdelgawad, Ahmed Hakeem

doi:10.21608/mjmr.2023.221039.1450

A randomized prospective study of the efficacy of ejaculation- preserving bipolar transurethral resection of prostate

Document Type : Original Article

Authors

¹ Urology department , faculty of medicine, minia university , Minya , Egypt

² Urology , faculty of medicine , minia university, minia, Egypt

³ Urology, faculty of medicine, minia university, minia, Egypt

⁴ Urology , faculty of medicine, minia university, minia, Egypt

10.21608/mjmr.2023.221039.1450

Abstract

Introduction: Bladder outlet blockage is a typical side effect of BPH in elderly men. When conservative therapy fails, surgical intervention [TURP] can produce satisfactory clinical and functional results. We changed the standard TURP approach to prevent resection of bladder neck and supramontanal tissues in order to maintain forward ejaculation.

Patients and Methods: Minia Urology Hospital's outpatient clinic conducted a prospective randomized trial to assess the preservation of antegrade ejaculation following bipolar TURP. The research included 40 male patients with normal sexual activity who had BPE and were candidates for surgery. The trial comprised men who had failed normal medical therapy for prolonged urine retention, infection, or hematuria. There was no evidence of prostate cancer, neurogenic bladder, urethral strictures, or sexual or ejaculation difficulties. All surgeries were carried out using a standard resectoscope and an ERBE BISTOURI VIO 300D with bipolar resection box.

Results: The present study included 40 males who had normal sexual activity and benign prostatic enlargement. The median age was 63.6 years. When compared to preoperative values, postoperative IPSS, IIEF, and ejaculation preservation are substantial.

Conclusion: The epTURP method was created as a successful minimally invasive surgery for patients experiencing severe urinary obstructive symptoms as a result of BPE and the need to sustain ejaculation. Bipolar TURP that preserves bladder neck and supramontanal ejaculation outperforms standard TURP in terms of forward ejaculation preservation, with equivalent effectiveness in micturition parameters.

Key Words: TURP, retrograde ejaculation, IPSS, IIEF, ejaculation preservation

Keywords