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Erectile and ejaculatory functions changes following bipolar versus monopolar transurethral resection of the prostate: a prospective randomized study

  • Urology - Original Paper
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Abstract

Objectives

To compare monopolar and bipolar transurethral resection of the prostate (M-TURP and B-TURP, respectively) focusing on erectile and ejaculatory functions in a randomized trial.

Methods

Between January 2013 and December 2014, all consecutive TURP candidates with benign prostatic hyperplasia (BPH) were prospectively randomized 1:1 into M-TURP/B-TURP arms and followed up at 2, and 4 weeks, 6 and 12 months after surgery. All patients were assessed using IIEF-15 (International index of erectile function-15) and Ej-MSHQ (ejaculatory domain-male sexual-health inventory). Changes in IIEF-15, its subdomains and Ej-MSHQ scores were compared between both intervention groups.

Results

Following M.TURP and B.TURP; 122 and 124 patients were included respectively and were considered for analysis at 1 year. Sexual function did not differ significantly between arms during follow-up (erectile function, P = 0.82; orgasmic function, P = 0.46; sexual desire, P = 0.29; intercourse satisfaction, P = 0.18; overall satisfaction, P = 0.92). There were no differences between arms in the distribution of EF evolution at any time compared with base line (at 12 months: M-TURP vs. B-TURP = improved, 24.5 vs. 26.6%; stable, 66.4 vs. 64.5%; deteriorated, 9.1 vs. 8.9%; P = 0.41). Newly developed erectile dysfunction (ED) was present in 8.2 and 7.3% of patients following M.TURP and B.TURP respectively and was related to presence of DM and obesity. Orgasm perception significantly reduced following M.TURP and B.TURP (P < 0.001). Newly reported ejaculatory dysfunction (Ej-MSHQ < 22) was significantly associated with low orgasm perception.

Conclusions

There were no differences between M-TURP/B-TURP in any aspect of sexual function.

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Authors and Affiliations

  1. Urology and Nephrology Center, Mansoura University, Mansoura, Egypt

    Ahmed El-Assmy, Ahmed M. ElShal, Ramy Mekkawy, Hamdy El-Kappany & El Housseiny I. Ibrahiem

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  1. Ahmed El-Assmy
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  2. Ahmed M. ElShal
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  3. Ramy Mekkawy
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  4. Hamdy El-Kappany
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  5. El Housseiny I. Ibrahiem
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Correspondence to Ahmed El-Assmy.

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All Authors declared that They have no conflict of interest.

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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was obtained from all individual participants included in the study.

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El-Assmy, A., ElShal, A.M., Mekkawy, R. et al. Erectile and ejaculatory functions changes following bipolar versus monopolar transurethral resection of the prostate: a prospective randomized study. Int Urol Nephrol 50, 1569–1576 (2018). https://doi.org/10.1007/s11255-018-1950-6

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  • DOI: https://doi.org/10.1007/s11255-018-1950-6

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