Ejaculatory Hood-Sparing Vaporization of the Prostate and Its Impact on Erectile, Ejaculatory, and Sexual Function

Abstract

Objective: To assess the impact of ejaculatory hood (EH)-sparing transurethral vaporization of the prostate (TUVP) on sexual function, with a specific focus on erectile and ejaculatory function.

Methods: We studied 25 patients who underwent EH-sparing Photo Selective Vaporization of the Prostate using the Greenlight Laser or Bipolar Button Plasma Vaporization of the Prostate from August 2016 to March 2018. All patients were sexually active with anterograde ejaculation prior to treatment. Patients completed the Male Sexual Health Questionnaire (MSHQ) and AUA Symptom Score pre- and postoperatively. We compared preprocedure sexual function with postprocedure sexual function at 1- and 3-month intervals. A logistic regression model was used to identify predictors of improvement in sexual function.

Results: Twenty-five patients underwent EH-sparing TUVP from August 2016 to March 2018. At 3-months postoperatively, patients had significant improvement in erection score (12 vs 9, P = .04) and erection bother score (5 vs 3.5, P <.01) compared to baseline. They also had improvement in ejaculation score (26 vs 23, P = .03), ejaculation bother score (5 vs 4, P = .01), and total MSHQ score (87.5 vs 73, P = .01). Anterograde ejaculation was preserved in 80.0% of patients. Logistic regression identified higher AUA score severity as an independent predictor of MSHQ score improvement (1.32, CI: 1.03-1.69, P = .03).

Conclusion: At 3 months postoperatively, the majority of men who underwent EH-sparing TUVP had preserved anterograde ejaculation and improved overall sexual function based on MSHQ survey. This validates EH-sparing TUVP in men with BPH who wish to maintain sexual function.