Purpose: We report our experience with 100 patients who underwent an innovative prostate enucleation technique that spares the complete urethral-plate from the veru montanum to the bladder neck using a low-energy thulium laser emission. The aim of our study was to evaluate the short-term effects of this procedure on ejaculation preservation and urinary obstruction. Materials and Methods: The International Prostate Symptom Index (IPSS), quality of life (QoL), and Male Sexual Health Questionnaire Ejaculatory Dysfunction (MSHQ-EJD) Short Form were used as validated instruments to quantify ejaculatory dysfunction before and 6 months after the surgery. Results: The median IPSS score pre- and postoperatively was 20 and 5, respectively (p < 0.0001); QoL dropped from a median of 4-1 (p < 0.0001); and the mean preoperative maximal flow rate improved significantly (8.5 vs 21.2 mL/min) (p < 0.0001). Furthermore, there was significant reduction in postvoid residual postoperatively (p < 0.0001). Postoperative ejaculatory function was preserved in 92/100 patients (92%). According to the MSHQ-EJD score, patients reported a slight nonsignificant decrease in frequency of ejaculation (item 1), force of expulsion (item 2) and reduction in semen volume during ejaculation (item 3), with the exception of ejaculation discomfort (item 4). Conclusion: According to our results, complete removal of the apical tissue, which has been advocated as an integral part of the so called ejaculatory hood, does not interfere with ejaculation if the ventral lissosphincter remains intact.

中文翻译：

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铥:YAG 激光保射前列腺剜除术的创新技术。

目的：我们报告了 100 名接受创新前列腺剜除技术的患者的经验，该技术使用低能量铥激光发射，保留了从前列腺到膀胱颈的整个尿道板。我们研究的目的是评估该手术对射精保存和尿路梗阻的短期影响。材料和方法：国际前列腺症状指数 (IPSS)、生活质量 (QoL) 和男性性健康射精功能障碍问卷 (MSHQ-EJD) 简表被用作量化术前和术后 6 个月射精功能障碍的有效工具。结果：术前和术后中位 IPSS 评分分别为 20 和 5（p < 0.0001）；生活质量从中位数 4-1 下降 (p < 0.0001)；术前平均最大流量显着改善（8.5 vs 21.2 mL/min）（p < 0.0001）。此外，术后排尿残留量显着减少（p < 0.0001）。92/100 名患者 (92%) 术后射精功能得以保留。根据 MSHQ-EJD 评分，患者报告射精频率（第 1 项）、射精力（第 2 项）和射精期间精液量减少（第 3 项）略有非显着性下降，但射精不适（第 3 项）除外。 4). 结论：根据我们的结果，如果腹侧软括约肌保持完整，完全去除顶端组织（一直主张作为所谓的射精罩的组成部分）不会干扰射精。