Photoselective Laser Vaporization of the Prostate in Benign Prostatic Obstruction: Sexual Function in Focus

The objective: to determine the effect of photoselective laser vaporization (FVP) on individual IIEF domains (sexual activity, libido, erection, ejaculation, ograzm, satisfaction with intercourse) in sexually active men with BPO, as well as the factors on which this effect depends. Materials and methods. 95 sexually active patients with benign prostatic obstruction (BPO) (prostate volume >40 cm3, maximum urinary flow rate Qmax <10 ml/s; QoL≥4) at the age of 45 to 60 years underwent FP (GreenLight XPS, MoxyFiber) ... Sexual function (IIEF), urination parameters (PSS/QoL, PVR, Qmax), prostate volume, intravesical prostate protrusion, PSA were assessed before the intervention and 3 months after. Results. PVP had a statistically significant and clinically significant effect on micturition parameters characterizing obstruction, prostate size and QoL. The median IPSSobstructive decreased by 6 (4–7) points (W=7.6; P<0.01), PVR by 48 (38–60) ml (W=6.2; P<0.01), IPP by 0.9 (0.5–1.5) cm (W=9.4; P<0.01) Vprostate at 31 (22–42) cm3 (W=8.5; P<0.01), QoL by 3 (2–4) points (W=11.2; P<0.01). The median Qmax increased by 23 (15–29) ml/s (W=13.3; P<0.01). The median values of the IPSSirritative and IPSSnocturia domains did not change significantly (P<0.8 and P<0.6, respectively). At 3 months after PVP, 84 (94.6 %) patients restored sexual activity. In 33 (39.28 %) of them, an improvement in erection and 15 (17.85 %) deterioration were found. 61 (72.26 %) lost emission. Conclusions. The most significant effect of PVP on ejaculatory function is the loss of emission. The effect of PVP on erection is multidirectional and manifests itself in its improvement and deterioration. Further research is needed to determine the mechanisms by which PVP affects erection and ejaculation in order to prevent negative effects.

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The Effect of Different Metabolic Syndrome

American Journal of Men s Health ◽

10.1177/1557988316638654 ◽

2016 ◽

Vol 11 (1) ◽

pp. 158-163 ◽

Cited By ~ 2

Author(s):

Orhan Ünal Zorba ◽

Hakkı Uzun ◽

Görkem Akça ◽

Selim Yazar

Keyword(s):

Metabolic Syndrome ◽

Symptom Score ◽

Flow Rate ◽

International Prostate Symptom Score ◽

Prostate Volume ◽

Specific Antigen ◽

Urinary Flow Rate ◽

Urinary Flow ◽

Significant Difference ◽

Maximum Urinary Flow

Because various criteria are used to define metabolic syndrome (MetS), this study examines the most relevant definition for patients with benign prostatic enlargement (BPE). Most studies regarding the link between MetS and BPE/lower urinary tract symptoms (LUTS) have used the National Cholesterol Education Program Adult Treatment Panel III criteria for diagnosis, while a few have used criteria from the International Diabetes Federation and/or American Heart Association. Patients with LUTS due to BPE are classified as having MetS or not by the aforementioned three definitions. Prostate volume, International Prostate Symptom Score, storage and voiding subscores, maximum urinary flow rate, and the postvoid urine of patients with and without MetS were compared separately in the three different groups. Surgical and medical treatment prevalence was also compared between three groups. No matter which definition was used, the International Prostate Symptom Score, the storage and voiding symptom scores, prostate volume, prostate-specific antigen, and postvoid urine were significantly higher in the patients with MetS. The maximum urinary flow rate was similar between patients with and without MetS, according to all three different definitions. There was no significant difference in the aforementioned parameter between patients with MetS diagnosed with the three different definitions. Irrespective of which definition was used, the surgical treatment rate was not significantly different in patients diagnosed with than without MetS, or between the patients with MetS diagnosed with the three different definitions. The authors suggest that it does not matter which of the aforementioned three definitions is used during the evaluation of MetS in men with BPE/LUTS.

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First Multi-Center All-Comers Study for the Aquablation Procedure

Journal of Clinical Medicine ◽

10.3390/jcm9020603 ◽

2020 ◽

Vol 9 (2) ◽

pp. 603 ◽

Cited By ~ 1

Author(s):

Thorsten Bach ◽

Peter Gilling ◽

Albert El Hajj ◽

Paul Anderson ◽

Neil Barber

Keyword(s):

Prostate Volume ◽

Transrectal Ultrasound ◽

Prostatic Hyperplasia ◽

Urinary Flow ◽

Procedure Time ◽

Symptomatic Benign Prostatic Hyperplasia ◽

Real World Evidence ◽

The Mean ◽

Maximum Urinary Flow

Waterjet-based prostate resection (Aquablation procedure) is an increasingly recognized treatment for symptomatic benign prostatic hyperplasia (BPH). We confirmed the safety and effectiveness of the Aquablation procedure in the commercial setting in 178 men at five sites. The mean prostate volume was 59 cc. The procedure time averaged 24 min and total anesthesia duration was 50 min. The International Prostate Symptom Score (IPSS) decreased from 21.6 at the baseline to 6.5 at the 12-month follow-up, a 15.3-point improvement (p < 0.0001). The maximum urinary flow rate increased from 10 cc/s at the baseline to 20.8 cc/s at month 12 (increase of 11.8 cc, p < 0.0001). Ejaculatory function was relatively preserved. Prostate volume assessed with transrectal ultrasound decreased 36% by month three. Five patients (2.7%) underwent a transfusion in the first week after the procedure. Real-world evidence shows that Aquablation is safe and effective for the treatment of BPH.

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Sexual dysfunctions after transurethral resection of the prostate (TURP): evidence from a retrospective study on 264 patients

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2015.1.8 ◽

2015 ◽

Vol 87 (1) ◽

pp. 8 ◽

Cited By ~ 23

Author(s):

Carlo Pavone ◽

Daniela Abbadessa ◽

Giovanna Scaduto ◽

Giovanni Caruana ◽

Cristina Scalici Gesolfo ◽

...

Keyword(s):

Sexual Function ◽

Sexual Activity ◽

Transurethral Resection ◽

Erectile Function ◽

International Standards ◽

Retrograde Ejaculation ◽

Sexual Dysfunctions ◽

Pathophysiological Mechanism ◽

Sexually Active ◽

The Impact

Objectives: Benign prostatic hyperplasia (BPH) and sexual dysfunctions are diseases with a high prevalence in aged men. Several studies have found a link between BPH and LUTS resulting from deterioration in sexual function in men aged 50 years and older for whom TURP is considered the gold standard. The impact of TURP on sexual functions still remain uncertain, nor is it clear what pathophysiological mechanism underlying the emergence of new episodes of Erectile Dysfunction (ED) following TURP in patients with normal sexual function before surgery, while retrograde ejaculation and ejaculate volume reduction represent a clear side effect; derived from BPH treatment. The aim of this study was to retrospectively evaluate the effects of transurethral resection of the prostate (TURP) on sexual function in patients operated in the period 2008-2012 at the Department of Urology of the University Hospital P. Giaccone, and at Villa Sofia-Cervello Hospital- Palermo. Secondary objective was to reconnect the sample data to interventional practice and international standards. Materials and methods: The retrospective longitudinal study was conducted on 264 of the 287 recruitable patients, aged between 50 and 85 years, suffering from BPH who underwent to TURP in the period 2008-2012. Telephone interviews were conducted and the International Index of Erectile Function (IIEF) was administered to assess sexual function. Patients enrolled were asked to respond to the test by referring at first to their sexual status in the period before surgery and subsequently to the state of their sexual function after treatment so as to obtain, for each patient, a pre- and post-TURP questionnaire in order to get comparisons that corresponding to reality and to avoid overestimation of the dysfunctional phenomenon. Results: In the pre-TURP, the 94.32% of the sample reported being sexually active, with good erectile function in 41.3% of cases, ED mild/moderate in 51.5% and complete ED in 1, 5% of cases; good libido in 62.9% of cases, lack of libido in 31.4% of cases and absent in 5.7% of cases (the latter data corresponded to patients not sexually active); to be sexually satisfied in 29.5% of cases, slightly dissatisfied in 11, 7% of cases, moderately in 35.3% of cases, dissatisfied and very dissatisfied in 23.5% of cases (of which 17.8% sexually active and 5.7% non-active).In the post-TURP 89.4% of the sample reported being sexually active, with good erectile function in 39.1% of cases, DE mild/moderate in 46.9% and complete DE in 4% of cases; good libido in 53.8% of cases, lack of libido in 33.7% of cases and absent in 13.5% of cases (including 1.9% of sexually active and 10.6% of non-active); to be sexually satisfied in 29.5% of cases, slightly dissatisfied in 9.5% of cases, moderately in 35.3% of cases, dissatisfied and very dissatisfied in 17.8% of cases (of which 14.8% sexually active and 10.6% inactive). Retrograde ejaculation was referred in 47.8% of those sexually active after TURP (42.8% if we consider the whole sample). Conclusions: TURP had no negative impact on erectile function in contrast to ejaculatory function. Of the109 patients with good erectile function in pre-TURP, 5.8% reported a worsening of erectile function after TURP. Among the 136 patients with ED moderate/mild pre-TURP 3.7% reported a worsening in the post-TURP, 16.2% reported an improvement, while 9.5% stopped any sexual activity. In 3.7% of the cases a complete ED was reported after TURP, while a decline of libido and sexual satisfaction was detected in all patients with worsening of sexual function. Retrograde ejaculation was observed in 48% of those sexually active after TURP. Particular attention has to be paid to the psychological aspects, bothbefore surgery and in the postoperative period, which may become an important factor in the decline of sexual activity.

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Sexual function, sexual activity, and quality of life in women with ovarian and endometrial cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.5051 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 5051-5051

Author(s):

Philipp Harter ◽

Inga Schrof ◽

Karl M Lehmann ◽

Rita Hils ◽

Verena Kullmann ◽

...

Keyword(s):

Quality Of Life ◽

Endometrial Cancer ◽

Sexual Function ◽

Sexual Activity ◽

Gynecological Cancer ◽

Control Group ◽

Sexually Active ◽

Case Control Studies ◽

Physical Problems

5051 Background: Gynecological cancer (GC) is generally assumed to have an impact on sexual function and activity. Although there are several studies addressing the issue, case control studies are currently limited. Methods: We performed a cross-sectional investigation of sexual function and activity utilizing the sexual activity questionnaire, the female sexual function index, and parts of the EORTC QLQ C30. Patients with gynecological cancer (GC) like ovarian and endometrial cancer were compared with a control group (C) of non-cancer patients. Inclusion of GC was only allowed if treatment was completed ≥12 months previously and patients were disease-free. Results: The questionnaires were sent out to 727 women (335 x GC and 392 x C), 22.8% of which responded. Response rates in both groups were equivalent (79 pts with GC [23.6%] and 87 control subjects [22.2%]). Median age was 57 years (C) and 62 years (GC), respectively (p=0.237). 51.5% (C) and 59.5% (GC) were not sexually active, mainly owing to lack of a partner (37%) or lack of interest (21%) in controls and lack of interest (40%, p<0.05), self-reported physical problems (31.9%, p<0.05), and physical problems of the partner (21%, p<0.05). There were significant differences between both groups in the SAQ discomfort score (p<0.05). We did not observe significant differences in quality of life or other scores regarding sexuality. Conclusions: About half of the women in both groups were not sexually active. However, reasons for non-activity differ. Quality of sexuality tends to be impaired in GC patients, but this seems not to influence quality of life. A shift of priority caused by substantial anxiety regarding cancer specific survival might explain our findings.

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Body Mass Index and Risk of Prostate Volume, International Prostate Symptom Score, Maximum Urinary Flow Rate, and Post-Void Residual in Benign Prostatic Hyperplasia Patients

American Journal of Men s Health ◽

10.1177/1557988319870382 ◽

2019 ◽

Vol 13 (4) ◽

pp. 155798831987038 ◽

Cited By ~ 1

Author(s):

Bing-Hui Li ◽

Tong Deng ◽

Qiao Huang ◽

Hao Zi ◽

Hong Weng ◽

...

Keyword(s):

Body Mass Index ◽

Benign Prostatic Hyperplasia ◽

Body Mass ◽

Flow Rate ◽

Prostate Volume ◽

Prostatic Hyperplasia ◽

Urinary Flow Rate ◽

Urinary Flow ◽

Increased Risk ◽

Maximum Urinary Flow

The objective of this study was to evaluate association between body mass index (BMI) and prostate volume (PV), international prostate symptom scores (IPSS), maximum urinary flow rate ( Qmax), and post-void residual (PVR) of Chinese benign prostatic hyperplasia (BPH) patients. All newly diagnosed BPH patients between September 2016 and August 2018 were selected and 788 patients were included. According to BMI, the patients were categorized into four groups, while according to PV, IPSS, Qmax, and PVR, they were categorized into two groups based on clinical significant cutoffs. Univariable and multivariable logistic regressions and a restricted cubic spline (RCS) were applied to explore the relationship of BMI with categorical PV, IPSS, Qmax, and PVR. Compared with normal BMI, obesity presented significant association with increased risk of larger PV (>80 ml) in both unadjusted and adjusted models (unadjusted odds ratio [OR] = 1.772, 95% CI [1.201, 2.614], p = .004; adjusted OR = 1.912, 95% CI [1.212, 3.017], p = .005); however, underweight or overweight did not present a significant connection with such risk. No significant effect was identified for BMI on IPSS, Qmax, or PVR in either unadjusted or adjusted model. Nonlinear test including BMI using RCS and adjusting for confounders showed no significance ( p > .05); however, a significant linear relationship was ascertained between BMI and the risk of larger PV ( p < .001). In conclusion, there was a significant linear association between BMI and the risk of larger PV in BPH patients. Hence, this suggests urologists should consider both BMI and PV when providing surgical treatment for BPH patients.

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Sexual Activity and Function in Patients With Gynecological Malignancies After Completed Treatment

International Journal of Gynecological Cancer ◽

10.1097/igc.0000000000000468 ◽

2015 ◽

Vol 25 (6) ◽

pp. 1134-1141 ◽

Cited By ~ 13

Author(s):

Donata Grimm ◽

Annette Hasenburg ◽

Christine Eulenburg ◽

Lisa Steinsiek ◽

Sebastian Mayer ◽

...

Keyword(s):

Quality Of Life ◽

Sexual Function ◽

Sexual Activity ◽

Gynecological Cancer ◽

Life Questionnaire ◽

Primary Therapy ◽

Sexually Active ◽

Quality Of Life Questionnaire ◽

Eortc Quality

ObjectiveSexual activity (SA) and sexual function (SF) after completion of treatment are central for quality of life (QoL) in women affected by gynecological cancer (GC). The aim of this study was to analyze the sexual outcome and overall QoL of women after treatment for primary GC compared with a healthy control group (CG).MethodsIn a multicenter cross-sectional study, 77 women aged 28 to 67 years were surveyed at least 12 months after completion of primary therapy for cervical, endometrial, or vulvar cancer [gynecological cancer group (GCG)]. Data were collected through validated questionnaires (Female Sexual Function Index-d, EORTC Quality of Life Questionnaire-C30, and Sexual Activity Questionnaire) and compared to a control of 60 healthy women (CG).ResultsIn the GCG, 41.3% were sexually active compared to 78.0% in the CG. Twelve women of the CG and 42 women of the GCG indicated the reasons for their sexual inactivity. The most common reason for sexual inactivity in the GCG was “the-presence-of-a-physical-problem” [18/42 (42.9%) vs 2/12 (16.7%) in the CG], whereas in the CG, “because-I-do-not-have-a-partner” was most common [6/12 (50.0%) vs 11/42 (26.2%) in the GCG]. Sexually active patients in the GCG had an SF comparable to the CG. In multivariate analysis of the total cohort (n = 137), relationship status [solid partnership vs living alone; odds ratio (OR), 33.82; 95% confidence interval (CI), 4.83–236.70], smoking (OR, 0.25; 95% CI, 0.06–1.03), and age (OR, 0.87; 95% CI, 0.79–0.94) influenced SA significantly. The probability of SA thereby decreased with increasing age. Quality of life and subjective general health status were not significantly different between the GCG and the CG (EORTC Quality of Life Questionnaire-C30 score 68.25 vs 69.67).ConclusionsA high number of patients with GC remain sexually inactive after treatment, indicating that women experience persistent functional problems. However, women who regain SA after completed treatment have a good overall SF and vice versa.

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Sexual function changes during the 5 years after high-dose treatment and hematopoietic cell transplantation for malignancy, with case-matched controls at 5 years

Blood ◽

10.1182/blood-2007-06-096594 ◽

2008 ◽

Vol 111 (3) ◽

pp. 989-996 ◽

Cited By ~ 66

Author(s):

Karen L. Syrjala ◽

Brenda F. Kurland ◽

Janet R. Abrams ◽

Jean E. Sanders ◽

Julia R. Heiman

Keyword(s):

Sexual Function ◽

Sexual Activity ◽

Cell Transplantation ◽

Hematopoietic Cell Transplantation ◽

Hematopoietic Cell ◽

High Dose ◽

Sexually Active ◽

Men And Women ◽

Female Survivors ◽

Function Recovery

Abstract This prospective study evaluated sexual function through 5 years after myeloablative allogeneic hematopoietic cell transplantation (HCT) for cancer to determine sexual function recovery and residual problems. Adults completed measures before HCT (N = 161), with survivors followed at 6 months and at 1, 2, 3, and 5 years. At 5 years case-matched controls also completed assessments. Analyses indicated that men and women differed in rates of being sexually active across time (P < .001) and in overall sexual function (P < .001). Both sexes declined in sexual activity rates and sexual function from before HCT to 6 months afterward (P ≤ .05). Activity rates recovered for men by 1 year (74%) and for women by 2 years (55%). Men improved from their 6-month nadir in sexual function by 2 years (P = .02), whereas women did not improve by 5 years (P = .17). Both male and female survivors were below controls in rates of sexual activity and sexual function at 5 years. Most women reported sexual problems (80% of survivors vs 61% of controls, P = .11); in contrast for men 46% of survivors versus 21% of controls (P = .05) reported problems. Thus, despite some recovery, sexual dysfunction remained a major problem for men and women after HCT. Aggressive efforts are needed to treat these deficits.

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Sexual Functioning in Pregnant Women

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16214216 ◽

2019 ◽

Vol 16 (21) ◽

pp. 4216

Author(s):

Anna Fuchs ◽

Iwona Czech ◽

Jerzy Sikora ◽

Piotr Fuchs ◽

Miłosz Lorek ◽

...

Keyword(s):

Sexual Function ◽

Sexual Activity ◽

Sexual Functioning ◽

First Trimester ◽

Married Women ◽

Sexually Active ◽

Mean Values ◽

Polish Version ◽

First Trimester Of Pregnancy ◽

The Mean

Sexual activity during pregnancy is determined by emotional, psychosocial, hormonal, and anatomical factors and varies during trimesters. This work aimed to establish women’s sexual activity during each trimester of pregnancy. A total of 624 women were included in the study and filled in the questionnaire three times, once during each trimester of pregnancy. The first part of the survey included questions about socio-demographic characteristics, obstetric history, and medical details of a given pregnancy. The second part was the Polish version of the female sexual function index (FSFI) questionnaire. Comparison of the mean scores for the overall sexual function of each trimester revealed clinically relevant sexual dysfunction in the second and third trimesters (mean values 25.9 ± 8.7 and 22.7 ± 8.7, respectively; p < 0.01). Women were most sexually active during their second trimester. In the first trimester of pregnancy, women were most likely to choose intercourse in the missionary position. Women with vocational education were characterized by the lowest and homogenous FSFI values. Total FSFI score depended on the martial status—the highest value pertained to married women (25.2 ± 6.9; p = 0.02).

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How does laparascopic lateral suspension affect the quality of life (QOL) and sexual activity?

Obstetrics & Gynecology International Journal ◽

10.15406/ogij.2020.11.00486 ◽

2020 ◽

Vol 11 (1) ◽

Author(s):

Adeviye Elçi Atılgan

Keyword(s):

Quality Of Life ◽

Sexual Function ◽

Sexual Activity ◽

Success Rate ◽

De Novo ◽

Low Frequency ◽

Life Questionnaire ◽

Sexually Active ◽

Turkish Women

Background: The affect of Laparascopic Lateral Suspension on quality of life and sexual activity in POP patients. Objective: This study aimed to investigate the quality of life (QOL) and sexual activity after Laparascopic Lateral Suspension (LLS) for pelvic organ prolapse (POP) in Turkish women. The practical success rate and complications related surgery were also analyzed. Study design: Prolapse Quality of Life Questionnaire (P-QOL) was used for investigate QOL in study group. Female Sexual Function Index (FSFI) was wielded for evaluating sexual function. Both tests were asked before the surgery and 12 months later. The results were recorded and retrospectively analyzed. Results: 237 patients were included in this study. Every P-QOL parameter was markedly recovered postoperatively. The complications detected after the surgery were; side pain 13 (5.5%), POP recurrence 4 (1.6%),de novo stress urinary incontinence 2 (0.8%), mesh erosion 1 (0.4%), and de novo dyspareunia 1 (0.4%).Cause of haven’t got any partner, 124 of the 237 patients (52.3%) reject to finish the FSFI. The rest 113 patients fulfilled the FSFI before and 79 patients completed the FSFI after the surgery. While 13 (5.4%) were sexually active before the surgery, 18 (7.5%) were sexually active after the surgery. The significantly increased domain after surgery was sexual function score with arousal. Conclusion: In this study, low frequency of sexual intercourse was found in Turkish POP population before and also after the operation. However, LLS technic proved fine QOL resuts with a high success rate. Its complications rate is also low. LLS is safe and effective for both sexually active and inactive POP patients.

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Clinical Significance of Intravesical Prostatic Protrusion Index in Patients with Clinical Diagnosis of Benign Prostatic Hyperplasia.

10.21203/rs.3.rs-329645/v1 ◽

2021 ◽

Author(s):

Seyed Reza Yahyazadeh ◽

Seyed Shahaboddin Izadi

Keyword(s):

Quality Of Life ◽

Benign Prostatic Hyperplasia ◽

International Prostate Symptom Score ◽

Prostate Volume ◽

Prostatic Hyperplasia ◽

Urinary Flow ◽

Postvoid Residual Urine ◽

Intravesical Prostatic Protrusion ◽

Maximum Urinary Flow

Abstract Purpose: To investigate the clinical significance of the intravesical prostatic protrusion (IPP) index in benign prostatic hyperplasia (BPH) patients to clarify its diagnostic value in predicting the clinical and structural abnormalities of the prostate. Materials and Methods: In this descriptive and analytical cross-sectional study, we include every man older than 50 years old with lower urinary tract symptoms (LUTS), predominantly voiding or obstructive, suggestive of BPH. The patients were evaluated to determine the following indices: IPSS (International Prostate Symptom Score) Index, QoL (quality of life), prostate volume (PV) and postvoid residual urine (PVR), serum PSA level, and the maximum urinary flow rate (Qmax) obtained by uroflowmetry. Subsequently, the assessment of the IPP index was undertaken by transabdominal ultrasonography. The categorization of the IPP index was done into 3 grades: grade one (below 5 mm), grade two (between 5 and 10 mm), and grade three (greater than 10 mm). Results: The significant direct correlation between the intravesical prostatic protrusion and international prostate symptom score, quality of life, prostate volume, postvoid residual urine, and serum PSA as well as inversely with the maximum urinary flow rate was confirmed both before and after the medical treatment. Also, the need for surgical intervention increased significantly with increasing IPP levels. Conclusion: The intravesical prostatic protrusion can be used to evaluate and predict the severity of symptoms and outcomes in patients with clinical BPH.

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