World journal of urology · 2026
Modified HoLEP technique: does it preserve ejaculation?
СтатьяРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Spezzi Roncero Lautaro German, Montelli Yanzi Guillermo, Cristallo Christian, Tirapegui Federico Ignacio, Santillan Diego, Gonzalez Mariano Sebastian
Аннотация
PURPOSE: The objective of this study is to evaluate whether the modified HoLEP technique can preserve antegrade ejaculation. The secondary objective is to assess postoperative prostatic symptoms and whether post-surgical ejaculatory function causes discomfort in patients.
METHODS: A prospective randomized study was conducted, including patients who underwent HoLEP at Hospital Italiano de Buenos Aires during 7 months. Patients were prospectively allocated to two groups; one group underwent the standard HoLEP technique, while the other underwent the modified technique (preservation 1 cm of peri-veru-montanum tissue). The study concluded 6 months post-surgery. Validated questionnaires (IPSS and "MSHQ-EjD Short Form") were used to evaluate prostatic symptoms and ejaculatory function.
RESULTS: 75 patients met the inclusion criteria. Patients were divided into two groups: Group A (37 patients) did not preserve peri-veru-montanum tissue, while Group B (38 patients) did. The mean change in IPSS for Group A was 13.9 (SD 5.9), and for Group B 14.2 (SD 6.2) (p = 0.835). The mean change in ejaculatory function was 7.5 (SD 5.2) for Group A and 8.1 (SD 4.1) for Group B (p = 0.619). 50 (66.6%) patients reported feeling "not at all" or "a little" bothered by their ejaculatory function post-surgery, while 12 (16%) patients reported feeling "very" or "extremely" bothered.
CONCLUSION: Preservation of peri-verumontanum tissue during HoLEP was not associated with improved preservation of antegrade ejaculation compared with the standard technique. Both groups showed significant improvement in lower urinary tract symptoms.
METHODS: A prospective randomized study was conducted, including patients who underwent HoLEP at Hospital Italiano de Buenos Aires during 7 months. Patients were prospectively allocated to two groups; one group underwent the standard HoLEP technique, while the other underwent the modified technique (preservation 1 cm of peri-veru-montanum tissue). The study concluded 6 months post-surgery. Validated questionnaires (IPSS and "MSHQ-EjD Short Form") were used to evaluate prostatic symptoms and ejaculatory function.
RESULTS: 75 patients met the inclusion criteria. Patients were divided into two groups: Group A (37 patients) did not preserve peri-veru-montanum tissue, while Group B (38 patients) did. The mean change in IPSS for Group A was 13.9 (SD 5.9), and for Group B 14.2 (SD 6.2) (p = 0.835). The mean change in ejaculatory function was 7.5 (SD 5.2) for Group A and 8.1 (SD 4.1) for Group B (p = 0.619). 50 (66.6%) patients reported feeling "not at all" or "a little" bothered by their ejaculatory function post-surgery, while 12 (16%) patients reported feeling "very" or "extremely" bothered.
CONCLUSION: Preservation of peri-verumontanum tissue during HoLEP was not associated with improved preservation of antegrade ejaculation compared with the standard technique. Both groups showed significant improvement in lower urinary tract symptoms.