Photoselective Laser Vaporization of the Prostate in Benign Prostatic Obstruction: Sexual Function in Focus

Authors

  • Ihor Gorpynchenko State Institution «Institute of Urology of NAMS of Ukraine»
  • Andrii Sytenko State Institution «Institute of Urology of NAMS of Ukraine»
  • Oksana Vintoniv Ivano-Frankivsk National Medical University

DOI:

https://doi.org/10.30841/2307-5090.4.2020.225648

Keywords:

sexual function, erection, ejaculation, photoselective laser vaporization of the prostate, green laser

Abstract

The objective: to determine the effect of photoselective laser vaporization (FVP) on individual IIEF domains (sexual activity, libido, erection, ejaculation, ograzm, satisfaction with intercourse) in sexually active men with BPO, as well as the factors on which this effect depends.

Materials and methods. 95 sexually active patients with benign prostatic obstruction (BPO) (prostate volume >40 cm3, maximum urinary flow rate Qmax <10 ml/s; QoL≥4) at the age of 45 to 60 years underwent FP (GreenLight XPS, MoxyFiber) ... Sexual function (IIEF), urination parameters (PSS/QoL, PVR, Qmax), prostate volume, intravesical prostate protrusion, PSA were assessed before the intervention and 3 months after.

Results. PVP had a statistically significant and clinically significant effect on micturition parameters characterizing obstruction, prostate size and QoL. The median IPSSobstructive decreased by 6 (4–7) points (W=7.6; P<0.01), PVR by 48 (38–60) ml (W=6.2; P<0.01), IPP by 0.9 (0.5–1.5) cm (W=9.4; P<0.01) Vprostate at 31 (22–42) cm3 (W=8.5; P<0.01), QoL by 3 (2–4) points (W=11.2; P<0.01). The median Qmax increased by 23 (15–29) ml/s (W=13.3; P<0.01). The median values of the IPSSirritative and IPSSnocturia domains did not change significantly (P<0.8 and P<0.6, respectively). At 3 months after PVP, 84 (94.6 %) patients restored sexual activity. In 33 (39.28 %) of them, an improvement in erection and 15 (17.85 %) deterioration were found. 61 (72.26 %) lost emission.

Conclusions. The most significant effect of PVP on ejaculatory function is the loss of emission. The effect of PVP on erection is multidirectional and manifests itself in its improvement and deterioration. Further research is needed to determine the mechanisms by which PVP affects erection and ejaculation in order to prevent negative effects.

Author Biographies

Ihor Gorpynchenko, State Institution «Institute of Urology of NAMS of Ukraine»

Ihor I. Gorpynchenko,

Head of Department of Sexopathology and Andrology

Andrii Sytenko, State Institution «Institute of Urology of NAMS of Ukraine»

Andrii M. Sytenko,

Department of Sexopathology and Andrology

Oksana Vintoniv, Ivano-Frankivsk National Medical University

Oksana R. Vintoniv,

Department of Urology

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Published

2021-03-15

Issue

Section

Sexology and andrology