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Ejaculation-Preserving Versus Conventional Dual Wavelength Diode Laser Vaporization of the Prostate
Sponsor: ALI KAMAL M. SAMI
Summary
Surgery to relieve urinary blockage caused by an enlarged prostate works well, but most men lose antegrade ejaculation afterwards, because semen passes backwards into the bladder instead of forwards. For sexually active men this is an important concern and a common reason for delaying or refusing surgery. This study compared two ways of performing the same operation, laser vaporization of the prostate using a dual-wavelength diode laser. In the conventional technique, prostate tissue is removed from the bladder neck all the way to the verumontanum. In the ejaculation-preserving technique, the surgeon deliberately leaves a 10 mm rim of tissue at the bladder neck untouched, and another 10 mm of tissue just before the verumontanum untouched, while removing the blocking tissue in between. Everything else about the operation, including the laser settings, was the same. Men were assigned to one of the two techniques by a computer-generated random sequence. They were assessed before surgery and again at 7 to 14 days, 1 month, 3 months, 6 months and 12 months after surgery. The main question was how many men still had antegrade ejaculation 3 months after surgery. The study also compared urinary symptoms, urine flow rate, residual urine volume, prostate size, erectile function, complications and patient satisfaction, to find out whether preserving ejaculation costs anything in terms of relieving the urinary blockage.
Official title: Ejaculation-Preserving Versus Conventional Dual-Wavelength Diode Laser Vaporization of the Prostate: A Randomized Comparative Study With 12-Month Follow up
Key Details
Gender
MALE
Age Range
50 Years - Any
Study Type
INTERVENTIONAL
Enrollment
119
Start Date
2024-10-05
Completion Date
2026-07-20
Last Updated
2026-08-20
Healthy Volunteers
No
Interventions
Conventional dual-wavelength diode laser vaporization of the prostate
Transurethral vaporization of the prostate using a Ceralas dual-wavelength diode laser (biolitec biomedical technology GmbH, Jena, Germany) emitting simultaneously at 980 nm and 1470 nm, bare-tip fibre, continuous wave, total power 140 W, delivered through a 22 Fr continuous-flow laser cystoscope sheath with normal saline irrigation, under spinal or general anaesthesia. Adenoma was vaporized from the bladder neck to the verumontanum without preservation margins.
Ejaculation-preserving dual wavelength diode laser vaporization of the prostate
Identical equipment, laser settings and anaesthesia to the comparator intervention, with two preservation margins: no vaporization within 10 mm distal to the bladder neck and none within 10 mm proximal to the verumontanum. Adequacy of the mid-prostatic channel was confirmed endoscopically at the end of the procedure. Adherence to both margins was recorded prospectively for every case.
Locations (1)
Royal Hospital, Department of Urology
Sulaymaniyah, Kurdistan, Iraq