Format

Send to

Choose Destination
Minerva Urol Nefrol. 2019 Sep 4. doi: 10.23736/S0393-2249.19.03588-4. [Epub ahead of print]

Anterograde ejaculation preservation after endoscopic treatments in patients with bladder outlet obstruction: systematic review and pooled-analysis of randomized clinical trials.

Author information

1
Department of Urology, University of Southern California, Los Angeles, CA, USA - giovanni.cacciamani@med.usc.edu.
2
Department of Urology, University of Southern California, Los Angeles, CA, USA.
3
Department of Urology, University of Verona, Verona, Italy.
4
Department of Urology, Careggi Hospital, University of Florence, Florence, Italy.
5
Departamento de Urología, Hospital la Paz, Madrid, Spain.
6
Departamento de Urología, São Marcos Hospital, Piauí, Brasil.
7
Department of Urology and Renal Transplantation, Bianchi-Melacrino-Morelli Hospital, Reggio Calabria, Italy.
8
Department of Urology, University of California, Irvine, CA, USA.
9
Department of Urology, San Raffaele Hospital, Milan, Italy.
10
Department of Urology and Pediatric Urology, University Medicine Mainz, Mainz, Germany.
11
Department of Urology, University of Turin San Luigi Hospital, Orbassano, Turin, Italy.
12
University of Catania, Catania, Italy.

Abstract

INTRODUCTION:

Despite the high rate of resolution, ejaculatory dysfunction (EjD) still is the most common side effect related to surgical treatment of bladder outlet obstruction (BOO). The aim of the present systematic review is to investigate how several technological treatment modalities for the management of LUTS/BOO compare in terms of functional and sexual outcomes.

EVIDENCE ACQUISITION:

All English language randomized controlled trials (RCT) assessing the impact of different endoscopic treatments for BOO were evaluated. We followed the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analyses) statement to evaluate PubMed®, Scopus®, and Web of ScienceTM databases (up to June 2019).

EVIDENCE SYNTHESIS:

Our electronic search identified a total of 2221 papers in PubMed, Scopus, and Web of Science. Of these, 142 publications were identified for detailed review, which yielded 21 included in the present systematic review. All groups appeared similar with regards to preoperative IPSS/AUA score, Qmax, and prostate volume (cc). Patients undergoing endoscopic treatments using ThuLEP, Greenlight or Prostate Artery Embolization techniques had lower-but not statistically significant- relative risk (RR) of retrograde ejaculation compared with conventional TURP (RR:0.90;p=0.35; RR: 0.71; p=0.1; RR0.73; p=0.11). Efficacy of those techniques was equal to TURP.

CONCLUSIONS:

Data reporting anterograde ejaculation preservation after endoscopic treatment in patients with BPE are sparse and heterogeneous. Pooled analyses suggest that new technological alternatives to conventional TURP might improve sexual outcomes, especially for non-ablative treatments.

Supplemental Content

Full text links

Icon for Minerva Medica
Loading ...
Support Center