What are the effects of ejaculation-sparing thulium laser enucleation of the prostate on sexual function in patients with lower urinary tract symptoms due to benign prostatic hyperplasia?

This study aimed to investigate the effects of an ejaculation sparing (ES) technique using thulium laser endoscopic enucleation (ThuLEP) of the prostate in patients with lower urinary tract symptoms (LUTS) as a result of benign prostatic hyperplasia (BPH). The findings suggested that ES-ThuLEP was safe, effective, and did not impact erectile function.  

LUTS is a collection of symptoms that include an urgency to urinate, urine leakage (incontinence), or discomfort passing urine. LUTS is often caused by BPH (enlarged prostate gland). Sexual dysfunction is also commonly caused by BPH. Standard treatments for BPH involve surgical procedures that can often impact ejaculation and sexual function.

Newer laser technologies have similar effects on BPH as surgical techniques. However, researchers believe that laser enucleation of the prostate (LEP; removal of the extra prostate tissue that blocks urine flow) may have less of an impact on ejaculation than standard treatments. There are multiple types of lasers that can be used. Thulium (ThuLEP) is one of the most common.

An ES technique has been developed using the ThuLEP technology. This spares a piece of prostate tissue located in the region of the prostate that affects ejaculation. The effectiveness and safety of ES-ThuLEP in patients with LUTS due to BPH, with respect to sexual function, are under investigation.

283 participants with LUTS due to BPH were included in this study. All patients received ES-ThuLEP. Patients were evaluated before treatment, and at 3 and 6 months after treatment. Changes in ejaculation, erection, and urinary symptoms were assessed.

There were significant improvements in the maximum urine flow rate, the average urine flow rate, and the severity of LUTS at 3 and 6 months. There was no significant difference in erectile function before and after treatment. 71.7% of participants had preserved ejaculation at 3 months and 77.4% of participants had preserved ejaculation at 6 months after treatment.

Some complications associated with treatment were urine retention (2.1% of participants) and additional treatment required for bleeding (1.1% of participants).

This study suggested that ES-ThuLEP was safe and effective for LUTS due to BPH with spared erectile and ejaculation function.

This study did not include a control group. This means that there was no group to compare the results of the treatment against. As a result, the true effects of the treatment may not be evident from this study. Also, the follow-up was rather short. Longer-term studies are needed.

If you have questions about the treatment of LUTS due to BPH, please contact your doctor.