الفهرس | Only 14 pages are availabe for public view |
Abstract Dissertation Abstract : Back ground : Benign prostatic hyperplasia (BPH) is a common disease of men above age of 50 (Lee et al., 2013). Loss of ejaculation is an adverse effect of standard Transurethral Resection of Prostste (TURP) that occurs in 65-80% of cases with decrease in sexual pleasure and ability to conceive .(Koca et al., 2014). Ejaculation preservation TURP has been by preservation of the paracollicular part and 1cm of tissue proximal to the veru (Alloussi et al., 2014). Recently, several techniques were used as an alternative to TURP with comparable outcome and increased safety. They included bipolar TURP, Green laser photoselective vaporization (PVP) of the prostate and plasma kinetic vaporization of the prostate (PKVP).To the best of our knowledge no one study has compared both techniques to the standard Bipolar TURP using ejaculation sparing technique. Aim of the work: To Evaluate and compare the outcome of ejaculation sparing management of BPH using 3 different techniques: PKVP, PVP and TURis. Patients: In this randomized controlled trial (RCT), 87 sexually active LUTS/BPH patients were assessed for eligibility. Methods: The patients were randomly allocated into 3 groups using a computer generated randomization with 1 : 1 : 1 ratio. Ejaculatory sparing PKVP, PVP and TURis were performed for patients of group 1, 2 and 3 respectively. Evaluation was based on ejaculation male sexual health questionnaire(Ej.MSHQ), simple question about ejaculation, International Index of Erectile Function (IIEF-15) questionnaire, International Prostate Symptom Score (IPSS), quality of life (QoL), uroflowmetry and post voiding residual (PVR). The therapeutic outcomes were assessed at 2 weeks, 1, 3 and 6 months weeks compared to the baseline. Results and conclusion: Ejaculation sparing technique can preserve ejaculation while improving urine flow parameters in sexually active patients with BPH. The 3 techniques revealed promising results with superiority of TURis. Reoperation (because of residual adenoma) remains a concern particularly after TURis. Recommendations: More studies with big number of patients are needed. |