MP13-02 IMPACT OF PROSTATE VOLUME ON SURGICAL EFFECTIVENESS AND SAFETY WITH XPS GREENLIGHT LASER. OUTCOMES OF A MULTICENTER RETROSPECTIVE STUDY

INTRODUCTION AND OBJECTIVES: We investigated patients’ perceptions of ejaculatory volume changes after HoLEP by using questionnaires. METHODS: A survey was performed from March to September 2014 using questionnaires regarding the patients’ satisfaction about voiding and sexual function, especially in ejaculatory volume changes. A total of 192 patients visited the outpatient clinic among 578 patients who underwent HoLEP by a single surgeon from August 2008 to September 2014. The questionnaires were composed of questions involving ejaculatory volumechanges, changesof orgasmic intensity on ejaculation, and the patient’s perception of ejaculatory volume reductions after HoLEP. RESULTS: 192 patients visited the outpatient clinic during the survey period and all of them answered the questionnaire. Among them, 91(47.4%) patients had sexual intercourse within the past 6 months and were included in the analysis. The ejaculatory volume changes after HoLEP were as follows: total loss of ejaculatory volume (n1⁄470, 76.9%), ejaculatory volume reduction (n1⁄417, 18.7%), and no change in ejaculatory volume (n1⁄44, 4.4%). Reduced orgasmic intensity was present in 48 patients (52.8%), whereas 43 patients (47.2%) reported no change or increased orgasmic intensity. Among the 87 patients who reported a total loss or reduction of ejaculatory volume, their perceptions of this were as follows: ‘feels better’ (n1⁄42, 2.3%), ‘not a problem’ (n1⁄414, 16.1%), ‘disappointed, but tolerable, due to improved voiding symptoms’ (n1⁄464, 73.6%), and ‘dissatisfied and want to reverse the situation to what it was before surgery’ (n1⁄47, 8.0%). There were no significant differences between patients’ ages at surgery, ages at survey, comorbidity, preoperative IPSS results, QoL index scores, IIEF scores, or significant postoperative changes between the patients who wanted to reverse the situation and the others. Among the 87 patients reporting a total loss or reduction of ejaculatory volume, there were more patients who reported decreased orgasmic intensity in those who wanted to reverse the situation compared with in the others (100% vs. 48.9% p1⁄40.027). CONCLUSIONS: Most patients reported reduced ejaculatory volumes following HoLEP. Over half experienced decreased orgasmic intensity after the surgery. Among the patients reporting total loss or decreased ejaculatory volume, 89.5% accepted the situation positively. However, 10.5% wanted to reverse the situation. Decreased orgasmic intensity might be the main reason for this dissatisfaction, although there were no preoperative predictors.