MP62-02 EJACULATORY PRESERVING MIDDLE LOBE ONLY - TRANSURETHRAL RESECTION AND VAPORIZATION OF THE PROSTATE: 12 YEAR EXPERIENCE (2018)

You have accessJournal of UrologyBenign Prostatic Hyperplasia: Surgical Therapy & New Technology I1 Apr 2018MP62-02 EJACULATORY PRESERVING MIDDLE LOBE ONLY - TRANSURETHRAL RESECTION AND VAPORIZATION OF THE PROSTATE: 12 YEAR EXPERIENCE Zeynep Gul, Bilal Chughtai, Alexis Te, and Steven Kaplan Zeynep GulZeynep Gul More articles by this author , Bilal ChughtaiBilal Chughtai More articles by this author , Alexis TeAlexis Te More articles by this author , and Steven KaplanSteven Kaplan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2003AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES After transurethral resection of the prostate (TURP), sexual adverse events, including erectile dysfunction (ED) and ejaculatory dysfunction (EjD), are significant concerns for patients. Using an intravesical prostatic protrusion (IPP) of ≥ 10 mm as the definition of a significant middle lobe, we report long-term safety and efficacy data on middle lobe only TURP (MLO-TURP). METHODS The study population consisted of 312 men (mean age 61.3 +/- 8.6) who presented with either significant LUTS (n = 147) or urinary retention (n = 175), had a minimum IPP of ≥ 10 mm, and were treated with either monopolar (n = 90) or bipolar (n = 222) MLO-TURP from 2005 to 2017. We evaluated: 1) efficacy: International Prostate Symptom Score (IPSS), Quality of Life (QoL), peak flow rate (Qmax), post-void residual urine (PVR), International Index of Erectile Function (IIEF) and ejaculatory function, which was assessed by the Male Sexual Health Questionnaire (MSHQ) and 2) Adverse events: catheterization time, blood transfusions, post-operative incontinence, and the need for subsequent therapy. Men were evaluated at 1 month, 6 months, and yearly thereafter. RESULTS Mean baseline prostate volume was 79.8 grams (30-178 grams); mean baseline IPP was 13.6. Improvements in IPSS, QoL, Qmax and PVR were durable throughout the study period (Table 1). There was no difference in outcomes between monopolar and bipolar MLO-TURPs. Postoperatively, the incidence of EjD was 2.6% (N = 8) and there was 1 case of new onset ED (0.3%). There was no significant deterioration of MSHQ-EjD at 5 years (baseline: 8.8 and at 5 years: 10.4) and there was modest improvement in bother due to ejaculatory function (baseline: 2.4 and at 5 years: 1.27). Seven (2.2%) patients required a second TURP and 1 patient required a blood transfusion. At 5 years, 14 (5.5%) men were on an alpha blocker and 6 (2.3%) were on an antimuscarinic medication. CONCLUSIONS MLO-TURP is a safe and effective treatment for men with LUTS. Patients experience long-term improvement of symptoms and preserve antegrade ejaculation. In select men with prominent middle lobes, MLO-TURP should be considered a therapeutic, ejaculation-sparing option. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e832 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Zeynep Gul More articles by this author Bilal Chughtai More articles by this author Alexis Te More articles by this author Steven Kaplan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...