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M.A. Egui Rojo, L. Redon Galvez, M. Alvarez Ardura, H. Otaola Arca, A. Páez Borda, HP-04-001 Monopolar Versus Bipolar Transurethral Resection of The Prostate: Evaluation of The Impact on Sexual Function, The Journal of Sexual Medicine, Volume 14, Issue Supplement_4a, April 2017, Page e150, https://doi.org/10.1016/j.jsxm.2017.03.041
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Objective
To evaluate the effects of monopolar and bipolar TURP (M-TURP and B-TURP), on overall sexual function.
Methods
From December 2014 to September 2016, 77 eligible candidates with BPH were prospectively randomized 1:1 into M-TURP/B-TURP arms (42 and 35 patients respectively) and followed up at 1 and 3 months. A univariate and multivariate analyses using the chi squared test and logistic regression were performed. We recorded the age, medical conditions such as hypertension and diabetes, history of smoking, preoperative prostatic volume, type of surgeon, resected grams, % of resected tissue and presence of retrograde ejaculation (RE). Prostatic symptoms and sexual function were quantified using self-administered IPSS and IIEF/5 scores at baseline and each subsequent visit.
Results
Mean age was 66 years (50-82). No statistical differences were found between both groups regarding medical comorbidities, preoperative IPSS and IIEF/5. Mean prostatic volume was 39 cc (10-69) and mean amount of resected tissue was 30 gr (6-100). At baseline 77,9% of patients had severe LUTS, and 37,7% had severe ED. Univariate analyses at first postoperative month shows that in both groups, history of diabetes mellitus, age and preoperative SHIM were associated with poor EF. However, multivariate analyses revealed that age was the only factor associated with a poor EF. These results were similar at 3 months. We did not found an association between surgeon experience, type of energy or % of resected tissue with the development of postoperative RE (39%). At first postoperative month 55% of patients still referring moderate prostatic symptoms and 50% had severe ED maintained at 3 months. There is a not significant decrease in EF at the M-TURP group at 1 and 3 months.
