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Standardized technique for ejaculation preservation during prostatic endoscopic ablative surgery

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Abstract

Purpose

Ejaculatory dysfunction is the most common side effect of benign prostatic hyperplasia surgery. Modified techniques have emerged with the aim of preserving antegrade ejaculation without compromising obstruction relief. None are standardized or validated. The PARTURP study is a randomized study investigating partial versus complete prostate resection. We conducted an investigator consensus meeting to define the ideal surgical technique to achieve both correct obstruction relief with ejaculation preservation.

Methods

An expert consensus meeting involving all investigators of the PARTURP study took place to define a common technique using the nominal group methodology. The objectives were to define the areas to be resected and the areas to be preserved; to define the criteria for proper obstruction relief; to define the criteria for proper ejaculation preservation.

Results

All investigators (n = 15) attended the consensus meeting, and agreement between all the participants was obtained. The anatomical landmarks to be preserved are located around the verumontanum and along the posterior part of the prostatic urethra. These structures must be preserved up to 2 cm from the verumontanum. The participants agreed on the need to preserve the urethral mucosa in all the areas to be preserved and to reach the enucleation plane in the areas of resection.

Conclusions

Anatomical landmarks for ejaculation-sparing surgery have been defined by the investigators of the PARTURP randomized study. These landmarks will be used during the study, and the clinical outcomes of this ejaculation-sparing technique will be compared with complete resection with up to 3 years follow-up.

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Data Availability

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Funding

This interventional research obtained funding from the French Ministry of Social Affairs and Health (PHRC National, 2019, no. 19-0048).

Author information

Authors and Affiliations

  1. Urology Department, University Hospital of Angers, CHU Angers, 4 Rue Larrey, 49933, Angers Cedex 9, France

    Souhil Lebdai

  2. Methodology Department, University Hospital of Bordeaux, Bordeaux, France

    Méric Ben Boujema, Antoine Benard & Florence Saillour

  3. Urology Department, Cochin Hospital, APHP, Paris Cité University, Paris, France

    Nicolas Barry Delongchamps

  4. Urology Department, Clinique Des Franciscaines, Versailles, France

    Amine Benchikh

  5. Urology Department, University Hospital of Tours, Tours, France

    Franck Bruyere

  6. Urology Department, Hôpital Privé Des Côtes D’Armor, Plérin, France

    Emmanuel Della Negra

  7. Urology Department, University Hospital of Limoges, Limoges, France

    Aurélien Descazeaud

  8. Urology Department, Hôpital Tenon, APHP, Paris, France

    Steeve Doizi

  9. Urology Department, CH Pays d’Aix, Aix en Provence, France

    Marc Fourmarier

  10. Urology Department, Hôpital Prive Francheville, Périgueux, France

    Richard Mallet

  11. Urology Department, Clinique Pasteur, Toulouse, France

    Vincent Misrai

  12. Urology Department, Hôpital Henri Mondor, APHP, Paris, France

    Tiphaine Pelegrin

  13. Urology Department, Polyclinique Saint Georges, Nice, France

    Yohan Rouscoff

  14. Urology Department, University Hospital of Lyon, Lyon, France

    Alain Ruffion

  15. EA 3738–CICLY EMR UCBL Lyon 1, Lyon, France

    Alain Ruffion

  16. Urology Department, University Hospital of Lille, Lille, France

    Arnaud Villers

  17. Urology Department, University Hospital of Bordeaux, Bordeaux, France

    Grégoire Robert

Authors
  1. Souhil Lebdai
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  2. Méric Ben Boujema
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  3. Antoine Benard
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  4. Nicolas Barry Delongchamps
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  5. Amine Benchikh
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  6. Franck Bruyere
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  7. Emmanuel Della Negra
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  8. Aurélien Descazeaud
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  9. Steeve Doizi
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  10. Marc Fourmarier
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  11. Richard Mallet
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  12. Vincent Misrai
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  13. Tiphaine Pelegrin
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  14. Yohan Rouscoff
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  15. Alain Ruffion
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  16. Arnaud Villers
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  17. Florence Saillour
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  18. Grégoire Robert
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Contributions

LR: project development, member of the nominal group committee, data collection, data interpretation, manuscript writing. S, BB, B: project development, data collection, data interpretation, manuscript reviewing. BD, B, B, P, DN, D, D, F, M, M, R, R, V: member of the nominal group committee, data collection, data interpretation, manuscript reviewing.

Corresponding author

Correspondence to Souhil Lebdai.

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Lebdai, S., Ben Boujema, M., Benard, A. et al. Standardized technique for ejaculation preservation during prostatic endoscopic ablative surgery. World J Urol 41, 3041–3049 (2023). https://doi.org/10.1007/s00345-023-04592-9

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