Presented by: Edoardo Tocci MD
University of Foggia

Introduction

Benign prostatic hypertrophy (BPH) is a common disease in aging males. Some patients under 50 years of age reported lower urinary tract disorders (LUTS) due to BPH. If desirous of paternity, drugs treatment remains the only one due to the risk of anejaculation after surgery. The first aim of the study was to report functional outcomes related to fertility preservation evaluated by sperm test in a population under 50 years of age who underwent UroLift.

Materials

Included 20 young men with LUTS from BPH assessed by the International Prostate Symptom Score (IPSS), with normal erectile (EF) and ejaculatory function (EjF) assessed by the International Index of Erectile Dysfunction (IIEF-5) and Male Sexual Health Questionnaire for Ejaculatory Dysfunction (MSHQ-EjD-SF). Semen analysis was performed before and 6 months after surgery with evaluation of pH, volume, sperm concentration, motility, vitality and morphology of sperms. All preoperatively underwent, uroflowmetry (UFM), digital rectal examination, transrectal prostate ultrasound to measure prostate volume, PSA, cystoscopy and urodynamics test if necessary. Urinary function was scheduled at 1,3, 6, 12 months with UFM, IPSS, IIEF-5, and MSHQ-EjD-SF. First PSA and cistoscopy were repeated at 6 month.

Results

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The mean age of the patients was 44.5 (36.5, 48) years. Mean operative time was 15 (10, 20) min and 2.5 (2, 4) implats per patients were used. At 3 months there were no difference in terms of total sperm count, volume, pH, motility, vitality, morphology, liquefaction, leucocytes (p=0.9; p=0.8; p=0.7; p=1; p=1; p=1; p=0,2; p=0.5). No patient presented retrograde ejaculation. Q-max increased by 64.4% (p = 0.001), PVR decreased by 66.6% (p= 0.016), and IPSS decreased by 60% (p < 0.001). IIEF and MSHQ-EjD-SF were similarly preserved (p=0.14, p=0.4).

Conclusion

We can conclude new findings regarding sparing of sperm parameters following UroLift, furthermore, no one reported retroejaculation or volume alteration. UroLift was confirmed to be effective as a technique in improving urinary functional disorders secondary to BPH.

Funding

none

Lead Authors

Nicola d'Altilia, MD
University of Foggia

Gian Maria Busetto, PHD
University of Foggia

Vito Mancini, MD
University of Foggia

Edoardo Tocci, MD
University of Foggia

Ugo Giovanni Falagario, MD
University of Foggia

Carlo Bettocchi, MD
University of Foggia

Giuseppe Carrieri, MD
University of Foggia

Pasquale Annese, MD
Policlinico Riuniti di Foggia