Effect of red laser and plasma transurethral enucleation of prostate on urinary function and sexual function in patients with benign prostatic hyperplasia under 65 years old
10.3760/cma.j.cn101721-20240824-00271
- VernacularTitle:红激光与等离子TUEP对65岁以下BPH患者排尿功能和性功能的影响
- Author:
Binbin ZHANG
1
;
Lingling DU
;
Hongxiong SONG
;
Yantao DANG
;
Wenshuai YAN
;
Jixue GAO
;
Feng WANG
;
Lijun MA
;
Longqiang LIU
Author Information
1. 延安大学附属医院泌尿外科，延安 716000
- Publication Type:Journal Article
- Keywords:
Benign prostatic hyperplasia;
Transurethral enucleation of prostate;
Plasma;
Red laser;
Urination status;
Sexual function
- From:
Clinical Medicine of China
2025;41(6):465-470
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the effects of red laser versus plasma transurethral enucleation of the prostate (TUEP) on urinary and sexual function in patients under 65 years of age with benign prostatic hyperplasia (BPH).Method:This study was a retrospective analysis. Eighty BPH patients under 65 years old, admitted to the Affiliated Hospital of Yan'an University between January 2020 and January 2023 were selected. Among them, 40 patients who underwent 980 nm semiconductor red laser TUERP with pre-resection of the urethral mucosa 1 cm proximal to the verumontanum at the prostatic apex and preservation of bladder neck integrity were assigned to the Red Laser Group. Another 40 patients who underwent conventional TURP with a plasma resectoscope were assigned to the Plasma Group. Clinical data and 6-month postoperative follow-up data were collected. Changes in the International Prostate Symptom Score (IPSS), maximum urinary flow rate (Qmax), International Index of Erectile Function-5 (IIEF-5) score, ejaculatory function score, and ejaculatory discomfort score before and after surgery were compared between the two groups. The incidence rates of decreased semen volume, retrograde ejaculation, and painful ejaculation at 6 months postoperatively were also compared.Results:At 6 months postoperatively, IPSS decreased in both groups compared to preoperative levels and was lower in the Red Laser Group than in the Plasma Group [(4.7±1.3) points vs. (6.3±2.2) points, t=-4.46, P<0.001]. Qmax increased in both groups compared to preoperative levels and was higher in the Red Laser Group than in the Plasma Group [(25.7±1.3) ml/s vs. (22.6±1.2) ml/s, t=10.76, P<0.001]. The ejaculatory function score in the Plasma Group was lower than its own preoperative level [(5.9±0.7) points vs. (11.1±1.6) points, t=5.33, P<0.001] and lower than that in the Red Laser Group [(5.9±0.7) points vs. (11.4±0.9) points, t=7.56, P<0.001]. The ejaculatory discomfort score in the Plasma Group was higher than its own preoperative level [(3.0±1.5) points vs. (0.8±0.6) points, t=4.26, P<0.001] and higher than that in the Red Laser Group [(3.0±1.5) points vs. (0.8±0.6) points, t=5.83, P<0.001]. The incidence rates of decreased semen volume and retrograde ejaculation in the Red Laser Group were lower than those in the Plasma Group [12.5% (5/40) vs. 50.0% (20/40), 10.0% (4/40) vs. 45.0% (18/40), χ2=15.84, 12.65, respectively, both P<0.001]. Conclusions:Using 980 nm semiconductor red laser TUERP with pre-resection of the urethral mucosa 1 cm proximal to the verumontanum and preservation of bladder neck integrity can improve urinary and sexual function in BPH patients under 65 years of age.
