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Re: Improvement of Erectile Function in Patients with Benign Prostatic Hyperplasia Undergoing Transurethral Plasmakinetic Resection of the Prostate
BENIGN PROSTATIC HYPERPLASIA
1769
Re: Improvement of Erectile Function in Patients with Benign Prostatic Hyperplasia Undergoing Transurethral Plasmakinetic Resection of the Prostate H. M. Zhang, J. H. Zheng, Y. F. Xu, B. Peng, Y. Yan and Q. R. Gao Department of Urology, Shanghai 10th People’s Hospital, Tongji University School of Medicine, Shanghai, China Int J Urol 2013; 20: 724e728.
Abstract available at http://jurology.com/ Editorial Comment: Sometimes you read an article and scratch your head and wonder. I had that experience when reviewing this study of 400 men who underwent either PlasmaKineticÔ resection of the prostate or standard transurethral prostatectomy (TURP). Not surprisingly, both procedures were effective in improving lower urinary tract symptoms. But what is interesting is that both groups had significantly improved erectile function scores (from 8 to 21.0). Historically there has been an association between TURP and postoperative de novo erectile dysfunction, although the risk is minimal. There are few physiological hypotheses and frankly fewer historical precedents to explain such a dramatic improvement in erectile function. The notion that the lack of capsular perforation and/or type of irrigant fluid will somehow improve erectile function appears to be a bit of an overstretch. While there is a recognized association between sexual and voiding dysfunction as men (and women) age, surgical improvement by TURP has not resulted in dramatic improvement in sexual function. On the contrary, issues of erection and ejaculation are usually part of our detailed informed consent. At this point I think few of us are ready to tout PlasmaKinetic resection of the prostate as a nuclear ViagraÒ. Steven A. Kaplan, MD
1769
Re: Improvement of Erectile Function in Patients with Benign Prostatic Hyperplasia Undergoing Transurethral Plasmakinetic Resection of the Prostate H. M. Zhang, J. H. Zheng, Y. F. Xu, B. Peng, Y. Yan and Q. R. Gao Department of Urology, Shanghai 10th People’s Hospital, Tongji University School of Medicine, Shanghai, China Int J Urol 2013; 20: 724e728.
Abstract available at http://jurology.com/ Editorial Comment: Sometimes you read an article and scratch your head and wonder. I had that experience when reviewing this study of 400 men who underwent either PlasmaKineticÔ resection of the prostate or standard transurethral prostatectomy (TURP). Not surprisingly, both procedures were effective in improving lower urinary tract symptoms. But what is interesting is that both groups had significantly improved erectile function scores (from 8 to 21.0). Historically there has been an association between TURP and postoperative de novo erectile dysfunction, although the risk is minimal. There are few physiological hypotheses and frankly fewer historical precedents to explain such a dramatic improvement in erectile function. The notion that the lack of capsular perforation and/or type of irrigant fluid will somehow improve erectile function appears to be a bit of an overstretch. While there is a recognized association between sexual and voiding dysfunction as men (and women) age, surgical improvement by TURP has not resulted in dramatic improvement in sexual function. On the contrary, issues of erection and ejaculation are usually part of our detailed informed consent. At this point I think few of us are ready to tout PlasmaKinetic resection of the prostate as a nuclear ViagraÒ. Steven A. Kaplan, MD