Benign prostat hiperplazisi tedavisinde TUR-P Monopolar/Bipolar , greenlight- fotoselektif Prostat Vaporizasyon PVP ve Transvezikal Prostatektomi TVP uygulamalarının cinsel fonksiyonlar üzerine olan etkileri

Abstract

Amaç: IIEF-15 sorgu formuyla BPH tedavisinde kullanılan cerrahi yöntemlerin cinsel fonksiyonlara olan etkileri incelenmiştir.Gereç ve Yöntemler: Çalışma Ocak 2008Haziran 2011 tarihleri arasında, BPH tanısı alan, 50-75 yaş aralığında, cinsel yönden aktif 80 erkek hasta çalışmaya dahil edildi. Hastalar, 4 eşit gruba ayrıldı. Prostat volümü 100 cc’nin altında olan üç gruba sırasıyla TUR-P monopolar, TUR-P bipolar, KTP green light lazer vaporizasyonu, prostat volümü 100 cc’nin üzerinde olan dördüncü gruba transvezikal prostatektomi TVP yapıldı. Hastaların preoperatif ve postoperatif IPSS, yaşam kalitesi QoL skoru ve IIEF-15 değerleri karşılaştırıldı.Bulgular: Çalışmamıza katılan 80 hastanın yaş ortalaması 63.4 ± 6.4, prostat hacimleri 81,17 ± 30,5 cc, IPSS semptom skoru 26±4,2 , yaşam kalitesi QoL skoru 5 ± 0,9 olduğu görüldü. Postoperatif dönemde IPSS skorunun 7,14±3,26’ya ve QoL’ın 1,37±0,59’a gerilediği izlendi p

Keywords

• Beningn prostat hiperplazisi,Monopolar

The effects of TUR-P Monopolar/Bipolar , greenlight-photoselective Vaporization of the Prostate PVP and Transvesical Prostatectomy TVP in the treatment of benign prostatic hyperplasia on Sexual function

Abstract

Objective: The effects of surgical techniques which used in BPH treatment by IIEF-15 query form on sexual function was investigated.Materials and Methods: The study was January 2008 - June 2011 between BPH diagnosed between the ages of 50-75, sexually active, 80 male patients were included in the study. Patients were divided into 4 equal groups. Prostate volume of the three groups, respectively under 100 cc TUR-P monopolar, bipolar TURP, KTP green light laser vaporization of the prostate volume 100 cc’s the fourth group on the transvesical prostatectomy TVP was performed. Preoperative and postoperative IPSS, quality of life QoL score and IIEF-15 values are compared.Results: The mean age of the 80 patients participating in our study, 63.4 ± 6.4, 81.17 ± 30.5 cc prostate volume, IPSS symptom score was 26 ± 4.2, quality of life QoL scores were found to be 5 ± 0.9. IPSS score in the postoperative period, 7.14 ± 3.26 to 1.37 ± 0.59 and QoL is ‘showed a decreased p

Keywords

• Benign Prostatic Hyperplasia, Monopolar, Bipolar, Greenlight, Sexual Function

References

1. Akkus E, Kadioglu A, Esen A, et al. Prevalence and corre- lates of erectile dysfunction in Turkey: a populationbased study. Eur Urol 2002;41:298-304.
2. Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999;281:537-44.
3. Braun M, Wassmer G, Klotz T, et al. Epidemiology of erec- tile dysfunction: results of the ‘Cologne Male Survey’. Int J Impot Res 2000;12:305-11.
4. Braun MH, Sommer F, Haupt G, et al. Lower urinary tract symptoms and erectile dysfunction: co-morbidity or typical ‘Aging Male’ symptoms? Results of the ‘Cologne Male Sur- vey’. Eur Urol 2003;44:588-94.
5. Rosen R, Altwein J, Boyle P, et al. Lower urinary tract symptoms and male sexual dysfunction: the multinatio- nal survey of the aging male (MSAM-7). Eur Urol 2003;44: 637-49.
6. (83)Andrea Tubaro, Simon Carter, Ahmad Hind, et al. A prospective study of the safety and efficacy of suprapubic transvesical prostatectomy in patients with benign prostatic hyperplasia. J Urol 2001;166:172-6.
7. Naspro R, Suardi N, Salonia A, et al. Holmium laser enuc- leation of the prostate versus open prostatectomy for pros- tates >70g: 24-month follow-up. Eur Urol. 2006 ;50:563-8.
8. Lindner A, Golomb J, Korczak D, et al. Effects of prostatec- tomy on sexual function. Urology 1991; 38:26–8.

9. Soderdahl D, Knight R, Hansberry K. Erectile dysfuncti- on following transurethral resection of the prostate. J Urol 1996;156:1354–6.
10. Tscholl R, Largo M, Poppinghaus H, et al. Incidence of erec- tile impotence secondary to transurethral resection of be- nign prostatic hyperplasia, assessed by preoperative and postoperative Snap Gauge tests. J Urol 1995;153:1491–3.
11. Madersbacher S, Marberger M, Donovan JL, et al. Is tran- surethral resection of the prostate still justified? Br J Urol 1999;83:227-37.
12. Rassweiler J, Teber D, Kuntz R, et al. Complications of tran- surethral resection of the prostate (TURP). Incidence, ma- nagement, and prevention. Eur Urol 2006 ;50:969-79.
13. Seong Beom Choi, Chen Zhao, Jong Kwan Park . The Effect of Transurethral Resection of the Prostate on Erectile Func- tion in Patients with Benign Prostatic Hyperplasia. Korean J Urol 2010;51:557-560.
14. Kaya C, Ilktaç A, Gokmen E, et al. The long-term results of transurethral vaporization of the prostate using plasmaki- netic energy. BJU Int 2007;99:845-848.
15. Akman T, Binbay M, Tekinarslan E,et al. Effects of bipo- lar and monopolar transurethral resection of the prostate on urinary and erectile function: a prospective randomized comparative study. BJU Int. 2012 Jun 6. doi: 10.1111/j.1464- 410X.2012.11266.x. (Epub ahead of print)
16. De la Rosette J, Alivizatos G, Madersbacher S, et al. EAU gu- idelines on benign prostatic hyperplasia (BPH). Eur Urol 2001;40: 256-63.
17. Alexis E, Terrence R, Malloy BS, et al. Photoselective vapo- rization of the prostate for the treatment of benign prosta- tic hyperplasia: 12-month results from the first United Sta- tes Multicenter Prospective Trial. J Urol 2004; 172: 1404-08.
18. Chandrasekera SK, Barber NJ, Walsh K, et al. High power 80W Nd:YAG/KTP laser vaporization of the prostate with 1 year follow up. Lasers Surg Med 2005;69: 1404-8.
19. Reich O, Bachmann A, Schneede P, et al. Experimental comparison of high power (80 W) potassium titanyl phosp- hate laser vaporization and transurethral resection of the prostate. J Urol 2004;171:2502-4.
20. Kuntzman RS, Malek RS, Barrett DM, et al. Potassium- titanyl-phosphate laser vaporization of the prostate: a com- parative functional and pathologic study in canines. Uro- logy 1996;48:575-83.
21. Malek RS, Kuntzman RS, Barrett DM. High power potassium-titanyl-phosphate laser vaporization prostatec- tomy. J Urol. 2000;163:1730-3.
22. Malek RS. Photoselective KTP laser vaporization of obs- tructive BPH (PVP). In: Baba S, Ono Y, editors. Interven- tional management of urological diseases. Tokyo: Springer- Verlag; 2006. pp. 103-122.
23. Rocco Damiano, Riccardo Autorino. Sexual Outcome Fol- lowing Photoselective Vaporization of the Prostate: Is There Enough Evidence ? Eur Urol 2010;58:214-15.
24. Paick JS, Um JM, Kim SW, et al. Influence of high-power potassiumtitanyl- phosphate photoselective vaporization of the prostate on erectile function: a short-term follow-up study. J Sex Med 2007; 4:1701–7.
25. Hamann MF, Naumann CM, Seif C, et al. Functional out- come following photoselective vaporisation of the prostate (PVP): Urodynamic findings within 12 months follow-up. Eur Urol 2008;54: 902-10.
26. Kavoussi PK, Hermans MR. Maintenance of erectile functi- on after photoselective vaporization of the prostate for obs- tructive benign prostatic hyperplasia. J Sex Med 2008;5: 2669-71.