Benign Prostate Hypertrophy(BPH)
Conditions
Brief summary
This study aims to compare the effect of holmium laser enucleation of the prostate (HoLEP) versus water vapor therapy (Rezum) on sexual function and ejaculation in patients with benign prostatic hyperplasia (BPH). Benign prostatic hyperplasia is a common condition affecting aging men and may lead to lower urinary tract symptoms requiring surgical intervention. While both HoLEP and Rezum are effective minimally invasive treatments, their impact on sexual function, particularly ejaculation, remains an important concern. Participants will be assigned to undergo either HoLEP or Rezum therapy. Sexual function and ejaculatory outcomes will be evaluated using validated questionnaires before and after treatment. The study aims to determine which modality provides better preservation of sexual function while maintaining clinical efficacy.
Detailed description
Benign prostatic hyperplasia (BPH) is a prevalent condition in aging males and is commonly associated with lower urinary tract symptoms (LUTS) that significantly affect quality of life. Surgical intervention is indicated in patients who fail medical therapy or present with complications. Holmium laser enucleation of the prostate (HoLEP) is considered a gold standard surgical treatment for BPH, offering durable outcomes and effective removal of prostatic adenoma. However, it is frequently associated with postoperative retrograde ejaculation. Water vapor thermal therapy (Rezum) is a minimally invasive treatment that uses convective water vapor energy to ablate prostatic tissue, with the potential advantage of preserving sexual and ejaculatory function. This prospective comparative study aims to evaluate and compare the effects of HoLEP and Rezum on sexual function and ejaculatory outcomes. Eligible patients with BPH will be allocated to one of the two treatment groups according to the study protocol. Primary outcomes include changes in sexual function and ejaculatory status assessed using validated questionnaires. Secondary outcomes include improvement in urinary symptoms and treatment-related complications. The findings of this study may help guide clinical decision-making by balancing treatment efficacy with preservation of sexual function.
Interventions
Holmium laser enucleation of the prostate is an endoscopic surgical procedure used for the treatment of benign prostatic hyperplasia. It involves complete enucleation of the prostatic adenoma using a holmium laser, followed by tissue morcellation.
PROCEDUREWater Vapor Thermal Therapy
Water vapor thermal therapy (Rezum) is a minimally invasive procedure that uses convective radiofrequency-generated water vapor to ablate hyperplastic prostatic tissue, aiming to relieve lower urinary tract symptoms while preserving sexual function.
Sponsors
Beni-Suef University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
MALE
Age
50 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Male patients aged 50 years or older * Diagnosed with benign prostatic hyperplasia (BPH) * Presence of lower urinary tract symptoms (LUTS) * International Prostate Symptom Score (IPSS) ≥ 13 * Peak urinary flow rate (Qmax) ≤ 15 mL/s * Failure of medical therapy for BPH * Sexually active and in a stable relationship
Exclusion criteria
* History of prostate cancer * Prior prostate surgery * Neurogenic bladder dysfunction * Urethral stricture disease * Active urinary tract infection * Severe comorbidities contraindicating surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Sexual Function | Baseline and 6 months after treatment | Change in sexual function assessed using validated patient-reported outcome measures (e.g., International Index of Erectile Function \[IIEF\] comparing baseline to post-treatment values.the IIEF score range from 5 to 25 with higher scores indicating better erectile function. |
| Change in ejaculatory function | Baseline and 6 months after treatment | Change in ejaculatory function assessed using validated patient-reported outcome measures (e.g., male sexual health questionnaire-Ejaculatory Dysfunction domain(MSHQ-EjD) comparing baseline to post-treatment values with higher scores indicating better ejaculatory function. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Lower Urinary Tract Symptoms Score (IPSS) | Baseline and 6 months after treatment | Change in lower urinary tract symptoms severity assessed using the International Prostate Symptom Score (IPSS) comparing baseline to post-treatment values. score range from 0 to 35 with higher scores indicating worse symptoms. |
Countries
Egypt
Outcome results
None listed