二极管激光前列腺摘除治疗良性前列腺增生:Leonardi射精保留技术的效果。

IF 1.3 Q3 UROLOGY & NEPHROLOGY
Archivio Italiano di Urologia e Andrologia Pub Date : 2025-09-30 Epub Date: 2025-09-11 DOI:10.4081/aiua.2025.14296
Rosario Leonardi, Guglielmo Mantica, Francesca Ambrosini, Antonio Tufano, Gabriele Iacona, Alessandro Calarco
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引用次数: 0

摘要

简介:良性前列腺增生(BPH)严重影响生活质量,并可能导致尿潴留和复发性感染等并发症。虽然内窥镜摘除技术提供了有效的缓解,但它们经常与正常射精的丧失有关。Leonardi保射精技术(LEST)是一种用于二极管激光前列腺去核术(DILEP)中保留射精功能的技术。方法:我们对2018年1月至2020年6月期间接受DILEP合并LEST的99名男性进行了观察性回顾性分析。纳入标准为有症状的前列腺增生,药物治疗难治性,前列腺体积≥40 mL,适合内窥镜手术。术前和6个月时评估功能结局(IPSS、Qmax、PVR)、勃起功能(IIEF-5)和射精状态(MSHQEjD)。用一份专门的5项问卷来评估患者满意度。结果:平均年龄为48.1岁,中位前列腺体积为67 mL。6个月时,IPSS从21.6下降到3.8,Qmax从9.1提高到25.7 mL/s, PVR从103下降到6.8 mL(所有p 80%愿意重复手术并否认后悔)。无重大并发症发生。结论:DILEP联合LEST具有良好的功能效果,射精保存率高,患者满意度高。这项技术可能代表了一种以患者为中心的前列腺增生手术选择,特别是在年轻男性优先考虑性功能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Diode laser enucleation prostate for benign prostatic hyperplasia: outcomes of the Leonardi ejaculation sparing technique.

Introduction: Benign prostatic hyperplasia (BPH) significantly impairs quality of life and may lead to complications such as urinary retention and recurrent infections. While endoscopic enucleation techniques provide effective relief, they are frequently associated with loss of antegrade ejaculation. The Leonardi Ejaculation-Sparing Technique (LEST) was developed to preserve ejaculatory function during diode laser enucleation of the prostate (DILEP).

Methods: We conducted an observational, retrospective analysis of 99 men undergoing DILEP with LEST between January 2018 and June 2020. Inclusion criteria were symptomatic BPH refractory to medical therapy, prostate volume ≥40 mL, and suitability for endoscopic surgery. Functional outcomes (IPSS, Qmax, PVR), erectile function (IIEF-5), and ejaculatory status (MSHQEjD) were assessed preoperatively and at 6 months. Patient satisfaction was evaluated with a dedicated 5-item questionnaire.

Results: Mean age was 48.1 years, and median prostate volume was 67 mL. At 6 months, IPSS decreased from 21.6 to 3.8, Qmax improved from 9.1 to 25.7 mL/s, and PVR decreased from 103 to 6.8 mL (all p<0.01). Erectile function showed modest improvement (IIEF-5: 14.4 to 16.2; p<0.01). Antegrade ejaculation was preserved in 94.1% of patients. Satisfaction was high, with > 80% willing to repeat the procedure and denying regret. No major complications occurred.

Conclusions: DILEP with LEST provides excellent functional results with high rates of ejaculatory preservation and patient satisfaction. This technique may represent a patient-centered alternative for BPH surgery, especially in younger men prioritizing sexual function.

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来源期刊
CiteScore
2.10
自引率
35.70%
发文量
72
审稿时长
10 weeks
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