{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T13:59:42Z","timestamp":1791813582629,"version":"4.3.4"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T00:00:00Z","timestamp":1751155200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Benign prostatic hyperplasia (BPH) significantly impacts patients' quality of life, both from a urinary and sexual perspective. Surgical techniques for the treatment of BPH, such as transurethral resection of the prostate and laser enucleation techniques, are associated with postoperative sexual and ejaculatory dysfunctions. For these reasons, there has been growing interest in minimally invasive techniques (MISTs), which aim to improve urinary symptoms while preserving erectile and ejaculatory function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Aim<\/jats:title>\n                  <jats:p>With this randomized trial (RCT), our aim is to analyze the impact of transperineal laser ablation (TPLA) and convective water vapor ablation (CWVA) on erectile and ejaculatory function of patients undergoing these MISTs and to compare the two techniques to assess any potential differences between them.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This RCT included 80 patients 1:1 randomized to TPLA and CWVA between January and July 2024 based on their International Prostate Symptoms Score. Inclusion criteria included prostate volume\u2009&amp;gt;\u200930\u00a0ml, age\u2009&amp;gt;\u200950\u00a0years, IPSS&amp;gt;7, PSA\u2009&amp;lt;\u20094\u00a0ng\/ml, and maximum flow rate\u2009&amp;lt;\u200915\u00a0ml\/s with post-void residual&amp;gt;50\u00a0ml. Categorical variables were compared using the \u03c72 test with Yates\u2019 correction or Fisher\u2019s exact test. A General Linear Model for repeated measures was used to evaluate within- and between-group differences over time.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Outcomes<\/jats:title>\n                  <jats:p>The Male Sexual Health Questionnaire\u2014Ejaculatory Dysfunction (MSHQ-EjD) and International Index of Erectile Function 5 (IIEF5) were collected 3- and 6-months after treatment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 61 sexually active patients (31 CWVA, 30 TPLA), baseline characteristics were comparable, except for a larger prostate volume in the TPLA group (P &amp;lt; 0.001). IIEF-5 scores remained stable at 6\u00a0months, with no significant differences between groups [19 (9-24) TPLA vs. 16.5 (1.75-20) CWVA, P\u2009=\u20090.11]. A transient decline at 3\u00a0months in the TPLA group resolved by 6\u00a0months. At 6\u00a0months, MSHQ-EjD scores improved significantly in both groups (+51% TPLA, +33.3% CWVA, P &amp;lt; 0.0001). The MSHQ-EjD Bother domain also showed significant improvement (P &amp;lt; 0.0001). All patients, except one, were same day discharged and were free from prostate medications at the last evaluation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Implications<\/jats:title>\n                  <jats:p>The results indicate that both TPLA and CWVA effectively preserve patients' sexual function.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Strengths and Limitations<\/jats:title>\n                  <jats:p>Although this is the first randomized study comparing these MISTs, the exclusion of sexually inactive patients from the analysis reduced the sample size. Furthermore, the findings are limited to short-term outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Both techniques effectively preserve erectile function and improve MSHQ-EjD scores.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jsxmed\/qdaf150","type":"journal-article","created":{"date-parts":[[2025,6,29]],"date-time":"2025-06-29T13:12:17Z","timestamp":1751202737000},"page":"1447-1454","source":"Crossref","is-referenced-by-count":10,"title":["Preserving erectile and ejaculatory function in patients undergoing minimally invasive techniques: the first randomized clinical trial comparing convective water vapor ablation and transperineal laser ablation"],"prefix":"10.1093","volume":"22","author":[{"given":"Alessandro","family":"Zucchi","sequence":"first","affiliation":[{"name":"Urology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Pisa 56126 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Bartoletti","sequence":"additional","affiliation":[{"name":"Urology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Pisa 56126 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petar","family":"Antonov","sequence":"additional","affiliation":[{"name":"Department of Urology and General Medicine, Medical University of Plovdiv , Plovdiv 4002 ,","place":["Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Salonia","sequence":"additional","affiliation":[{"name":"Division of Oncology\/Unit of Urology, Urological Research Institute, IRCCS Ospedale San Raffaele , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atanas","family":"Ivanov","sequence":"additional","affiliation":[{"name":"Department of Urology and General Medicine, Medical University of Plovdiv , Plovdiv 4002 ,","place":["Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giada","family":"Macr\u00ec","sequence":"additional","affiliation":[{"name":"Urology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Pisa 56126 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleonora","family":"Sollazzi","sequence":"additional","affiliation":[{"name":"Urology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Pisa 56126 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Autorino","sequence":"additional","affiliation":[{"name":"Department of Urology, RUSH University , Chicago, IL 60612 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Liguori","sequence":"additional","affiliation":[{"name":"Urology Department, University of Trieste , Trieste 34123 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittorio","family":"Bini","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, University of Perugia , Perugia 06123 ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Pacini","sequence":"additional","affiliation":[{"name":"Urology Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa , Pisa 56126 ,","place":["Italy"]},{"name":"Department of Urology and General Medicine, Medical University of Plovdiv , Plovdiv 4002 ,","place":["Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,6,29]]},"reference":[{"issue":"Suppl 9","key":"2025080406265935100_ref1","first-page":"S3","article-title":"Benign prostatic hyperplasia: an overview","volume":"7","author":"Roehrborn","year":"2005","journal-title":"Rev Urol"},{"issue":"1","key":"2025080406265935100_ref2","doi-asserted-by":"publisher","first-page":"7984","DOI":"10.1038\/s41598-017-06628-8","article-title":"The global burden of lower urinary tract symptoms suggestive of benign prostatic hyperplasia: a systematic review and meta-analysis","volume":"7","author":"Lee","year":"2017","journal-title":"Sci Rep"},{"issue":"8765","key":"2025080406265935100_ref3","doi-asserted-by":"publisher","first-page":"469","DOI":"10.1016\/0140-6736(91)90543-X","article-title":"High prevalence 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