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A Systematic Review of Reported Ejaculatory Dysfunction in Clinical Trials Evaluating Minimally Invasive Treatment Modalities for BPH

  • Benign Prostatic Hyperplasia (K McVary, Section Editor)
  • Published:
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Abstract

Purpose of Review

To explore the sexual outcomes following the novel minimally invasive surgical procedures for benign prostatic hyperplasia- (BPH-) related lower urinary tract symptoms (LUTS), with an emphasis on ejaculatory dysfunction (EjD).

Recent Findings

A database search with a 10-year time restriction was carried out until February 20, 2020 using MEDLINE through the PubMed Platform evaluating minimally invasive treatment modalities for BPH and their effect on EjD. After the article selection, we retrieved data for men randomized in 19 different studies with results in 40 separate published articles investigating minimally invasive BPH surgery and reporting EjD rates. To date, water vapor thermal therapy or Rezūm, prostatic urethral lift (PUL) or UroLift®, prostate artery embolization (PAE), and Aquablation showed acceptable rates (< 2%) of retrograde ejaculation by 1 year and had very low adverse events related to the procedure. Both PUL and Rezūm demonstrated lower rates when compared with PAE and Aquablation.

Summary

With comparable sexual side effect profiles postoperatively, clinicians may determine which therapeutic modality is optimal for patients based on efficacy and cost-benefit. Further randomized clinical trials are required to directly compare the effect of novel minimally invasive surgical procedures for BPH-related LUTS on ejaculation and sexual function.

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Data Availability

This is a literature review, all data is available through online peer reviewed articles.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Urology, Yale Univeristy School of Medicine, 333 Cedar Street, New Haven, CT, 06520-8058, USA

    Soum D. Lokeshwar

  2. Department of Urology, Miller School of Medicine, University of Miami, 1120 NW 14th Street, 15th Floor, Miami, FL, 33136, USA

    David Valancy, Thiago Fernandes Negris Lima, Ruben Blachman-Braun & Ranjith Ramasamy

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Lokeshwar, S.D., Valancy, D., Lima, T.F.N. et al. A Systematic Review of Reported Ejaculatory Dysfunction in Clinical Trials Evaluating Minimally Invasive Treatment Modalities for BPH. Curr Urol Rep 21, 54 (2020). https://doi.org/10.1007/s11934-020-01012-y

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