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BMC Urology
Published in: BMC Urology 1/2021

01-12-2021 | Erectile Dysfunction | Research article

Significant relationship between parameters measured by transrectal color Doppler ultrasound and sexual dysfunction in patients with BPH 12 months after TURP

Authors: Li K. Chen, Yu W. Lai, Li P. Chiu, Saint Shiou-Sheng Chen

Published in: BMC Urology | Issue 1/2021

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Abstract

Background

A link between sexual dysfunction and lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) has been noticed. Transurethral resection of the prostate (TURP) remains the standard treatment for symptomatic BPH, whether TURP causes sexual dysfunction is still uncertain. In this retrospective study, we investigated the relationship between parameters measured by color Doppler ultrasound (CDU) and sexual dysfunction in patients with BPH 12 months after TURP.

Methods

The parameters include presumed circle area ratio (PCAR), maximal horizontal area of seminal vesicles (MHA), resistive index of the prostate (RIP), and peak systolic velocity in the flaccid penis (PSV). The international prostate symptom score was used to evaluate the lower urinary tract symptoms and the five-item version of the International Index of Erectile Function was used to evaluate sexual function before and after TURP.

Results

Of the 103 patients without sexual dysfunction before TURP, 11 (10.7%) had erectile dysfunction (ED) after TURP. These 11 patients had significantly lower PCAR, RIP, PSV and MHA than those without ED. The patients with retrograde ejaculation after TURP had significantly lower PCAR than those without retrograde ejaculation, and the patients with premature ejaculation after TURP had significantly lower MHA than those without premature ejaculation. Comparing the parameters between baseline and after TURP, PCAR, RIP, and MHA decreased significantly in the patients with sexual dysfunction, but no significant differences were noted in the patients without sexual dysfunction after TURP.

Conclusions

More extended TURP can lead to a higher incidence of ED and retrograde ejaculation in BPH patients without sexual dysfunction before TURP. Patients with a lower volume of seminal vesicles after TURP may have a higher incidence of premature ejaculation.
Literature
1.
Delay KJ, Nutt M, McVary KT. Ejaculatory dysfunction in the treatment of lower urinary tract symptoms. Trans Androl Urol. 2016;5:450–9.CrossRef
2.
Mebust WK, Holtgrewe HL, Cockett AT, Peters PC. Transurethral prostatectomy: immediate and post-operative complications. A cooperative study of 13 participating institutions evaluating 3885 patients. J Urol 1989;141:243−247.
3.
Holtgrewe HL, Mebust WK, Dowd JB, Cockett AT, Peters PC, Proctor C. Transurethral prostatectomy: practice aspects of the dominant operation in American urology. J Urol. 1989;141:248–53.CrossRefPubMed
4.
Mayer EK, Kroeze SG, Chopra S, Bottle A, Patel A. Examining the ‘gold standard’: a comparative critical analysis of three consecutive decades of monopolar transurethral resection of the prostate (TURP) outcomes. BJU Int. 2012;110:1595–601.CrossRefPubMed
5.
Roos NP, Wennberg JE, Malenka DJ, Fisher ES, McPherson K, Andersen TF, et al. Mortality and reoperation after open and transurethral resection of the prostate for benign prostatic hyperplasia. New Eng J Med. 1989;320:1120–4.CrossRefPubMed
6.
Pavone C, Abbadessa D, Scaduto G, Caruana G, Gesolfo CS, Fontana D, et al. Sexual dysfunction after transurethral resection of the prostate (TURP): evidence from a retrospective study on 264 patients. Arch Ital Urol Androl. 2015;87:8–13.CrossRefPubMed
7.
Muntener M, Aelig S, Kuettel R, Gehrlach C, Sulser T, Strebel RT. Sexual function after transurethral resection of the prostate (TURP): results of an independent prospective multicenter assessment of outcome. Eur Urol. 2007;52:510–6.CrossRefPubMed
8.
Thumann RC Jr. Estimation of the weight of the hyperplasia prostate from the cystourethrogram. Am J Roentgenol Radium Ther. 1951;65(4):593–4.PubMed
9.
Kaplan SA, Te AE, Pressler LB, Olsson CA. Transition zone index as a method of assessing benign prostatic hyperplasia: correlation with symptoms, urine flow and detrusor pressure. J Urol. 1995;154:1764–9.CrossRefPubMed
10.
Watanabe H, Igari D, Tanahashi Y, Harada K, Saitoh M. Measurements of size and weight of prostate by means of transrectal ultrasonotomography. Tokohu J Exp Med. 1974;114:277.CrossRef
11.
12.
Matsugasumi T, Fujihara A, Ushijima S, Kanazawa M, Yamada Y, Shiraishi T, et al. Morphometric analysis of prostate zonal anatomy using magnetic resonance imaging: impact on age-related changes in patients in Japan and the USA. BJU Int. 2017;120:497–504.CrossRefPubMed
13.
Hastak SM, Gammelgaard J, Holm HH. Transrectal ultrasonic volume determination of the prostate- a preoperative and postoperative study. J Urol. 1982;127:1115–58.CrossRefPubMed
14.
Chen SS, Hong JG, Hsiao YJ, Chang LS. The correlation between clinical outcome and residual prostatic weight ratio after transurethral resection of the prostate for benign prostatic hyperplasia. BJU Int. 2000;85:79–82.CrossRefPubMed
15.
Watanabe H, Kaiho H, Tanaka M, Terasawa Y. Diagnostic application of ultrasonotomography to the prostate. Invest Urol. 1971;8:548–59.PubMed
16.
Tewari A, Indudhara R, Shinohara K, Schalow E, Woods M, Lee RTR, et al. Comparison of transrectal ultrasound prostatic volume estimation with magnetic resonance imaging volume estimation and surgical specimen weight in patients with benign prostatic hyperplasia. J Clin Ultra. 1996;24:169–74.CrossRef
17.
18.
Mclean AJ. The bovine electrosurgical current generator: some underlying principles and results. Arch Surg. 1929;18:1863–7.CrossRef
19.
Chiu AW, Chen MT, Chang LS, Huang JK, Chen KK, Lin AT, et al. Prophylactic bladder neck incision in the treatment of small benign prostatic hyperplasia. Chin Med J. 1990;45(1):22–5.
20.
21.
Tscholl R, Largo M, Poppinghaus E, Recker F, Subotic B. Incidence of erectile impotence secondary to transurethral resection of benign prostatic hyperplasia, assessed by preoperative and postoperative snap gauge tests. J Urol. 1995;153:1491–3.CrossRefPubMed
22.
Marshall FF, editor. Textbook of operative urology. Philadelphia: WB Saunders; 1996. p. 13p.
23.
McVary KT, Roehrborn CG, Avins AL, Barry MJ, Bruskewitz RC, Donnell RF, et al. Update on AUA Guideline on the Management of Benign Prostatic Hyperplasia. J Urol. 2011;185:1793–803.CrossRefPubMed
24.
Favilla V, Comino S, Salamone C, Fragala E, Madibua M, Condorelli R, et al. Risk factors of sexual dysfunction after transurethral resection of the prostate (TURP): a 12 months follow-up. J Endocrinol Invest. 2013;36:1094–8.CrossRefPubMed
25.
Corona G, Fagioli G, Mannucci E, Romeo A, Lotti F, Sforza A, et al. Penile Doppler ultrasound in patients with erectile dysfunction (ED): role of peak systolic velocity measured in the flaccid state in predicting arterigenic ED and silent coronary artery disease. J Sex Med 2008;5:2623−2624.
26.
Tuncel A, Toprak U, Balci M, Koseoglu E, Aksoy Y, Karademir A, Atan A. Impact of transrectal prostate needle biopsy on erectile function: results of power Doppler ultrasonography of the prostate. Kaoshing J Med Sci. 2014;30:194–9.
27.
Zisman A, Leibovici D, Kleinmann J, Siegel YI, Lindher A. The impact of prostate biopsy on patients well being: a prospective study of pain, anxiety and erectile dysfunction. J Urol. 2001;165:445–54.CrossRefPubMed
28.
Hellstrom WJ, Giuliano F, Rosen RC. Ejaculatory dysfunction and its association with lower urinary tract symptoms of benign prostatic hyperplasia and BPH treatment. Urology. 2009;74:15–21.CrossRefPubMed
29.
Fedder J, Kaspersen MD, Brandslund I, Hojgaard A. Retrograde ejaculation and sexual dysfunction in men with diabetes mellitus: a prospective, controlled study. Andrology. 2013;1:602–6.CrossRefPubMed
30.
Wasson JH, Bubolz TA, Lu-Yao GL, Walker-Corkery E, Hammond CS, Barry MJ. Transurethral resection of the prostate among medicare beneficiaries: 1984 to. For the patient outcomes research team for prostatic diseases. J Urol. 1997;2000(164):1212–5.
31.
Rosen R, Altwein J, Boyle P, Kirby RS, Lukacs B, Meuleman E, et al. Lower urinary tract symptoms and male sexual dysfunction: the multinational survey of the aging male (MSAM-7). Eur Urol. 2003;44:637–49.CrossRefPubMed
Metadata
Title
Significant relationship between parameters measured by transrectal color Doppler ultrasound and sexual dysfunction in patients with BPH 12 months after TURP
Authors
Li K. Chen
Yu W. Lai
Li P. Chiu
Saint Shiou-Sheng Chen
Publication date
01-12-2021

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