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16.09.2023 | Original Article

Standardized technique for ejaculation preservation during prostatic endoscopic ablative surgery

verfasst von: Souhil Lebdai, Méric Ben Boujema, Antoine Benard, Nicolas Barry Delongchamps, Amine Benchikh, Franck Bruyere, Emmanuel Della Negra, Aurélien Descazeaud, Steeve Doizi, Marc Fourmarier, Richard Mallet, Vincent Misrai, Tiphaine Pelegrin, Yohan Rouscoff, Alain Ruffion, Arnaud Villers, Florence Saillour, Grégoire Robert

Erschienen in: World Journal of Urology | Ausgabe 11/2023

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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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Titel: Standardized technique for ejaculation preservation during prostatic endoscopic ablative surgery
verfasst von: Souhil Lebdai
Méric Ben Boujema
Antoine Benard
Nicolas Barry Delongchamps
Amine Benchikh
Franck Bruyere
Emmanuel Della Negra
Aurélien Descazeaud
Steeve Doizi
Marc Fourmarier
Richard Mallet
Vincent Misrai
Tiphaine Pelegrin
Yohan Rouscoff
Alain Ruffion
Arnaud Villers
Florence Saillour
Grégoire Robert
Publikationsdatum: 16.09.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: World Journal of Urology / Ausgabe 11/2023
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-023-04592-9

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Standardized technique for ejaculation preservation during prostatic endoscopic ablative surgery