Comparison of Functional Outcomes of Ejaculation-preserving Partial Trans Urethral Resection of the Prostate With Complete Trans Urethral Resection of the Prostate for Benign Prostatic Obstruction (PARTURP)

University Hospital of Bordeaux

Status: Enrolling

Conditions: Benign Prostatic Hyperplasia

Treatments: Procedure: Conventional endoscopic prostatic surgery; Procedure: Partial surgery preserving the prostatic apex

Study type: Interventional

Funder types: Other

Identifiers

NCT05574244

CHUBX 2019/57

Details and patient eligibility

About

It has been demonstrated that sexual activity was common in the majority of men over 50 years old and was an important component of overall quality of life (QoL). Ejaculatory dysfunction (EjD) is the most common side effect of surgical treatment of benign prostatic obstruction (BPO). It has been considered for decades to be an inevitable consequence of restoring micturition comfort. EjD can have a substantial deleterious effect on the QoL of men with previously maintained regular sexual activity, inducing decreased orgasmic intensity and increased levels of anxiety and depression. A better understanding of the physiology of ejaculation has enabled the emergence of modified surgical techniques that aim to preserve antegrade ejaculation. Our hypothesis is that conservation of ejaculation can be achieved by modified surgical procedures without compromising functional outcomes.

Full description

The aim of this study is To compare the efficacy of partial trans urethral resection of the prostate versus conventional resection of the prostate in improvement of lower urinary tract symptoms related to benign prostatic hyperplasia at 6 months. The secondary objectives are to compare the impacts of partial prostatic endoscopic surgery versus conventional endoscopic surgery on ejaculatory function, lower urinary tract symptoms, Global sexual life, Urinary flow, complication related to the surgery and the rates of re-treatment.

Investigators use a non-inferiority comparative single blinded (patient) multicenter randomized clinical trial in two parallel groups (Conventional endoscopic prostatic surgery Vs Partial surgery preserving the prostatic apex.

Enrollment: 336 estimated patients

Sex: Male

Ages: 40+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Man over 40 years old
• Indication of surgical management for BPH
• Prostate volume ≥30 cc and ≤150 cc as evaluated by ultrasonography ( or an MRI if available)
• IPSS score ≥12
• Qmax ≤15 ml/s
• Affiliated to French national social security system
• wish and be able to comply with planned visits
• Able to express his consent
• Signed informed consent form

Exclusion criteria

• Unwillingness to accept the treatment
• No pre-operative ejaculation or sexuality
• Neurological pathology responsible for micturition disorders
• History of prostatic surgery
• Stenosis of the urethra symptomatic
• History of prostate cancer
• History of radiotherapy or pelvic surgery
• Patient refusing the principle of partial surgery
• Life expectancy <3 years
• Inability to understand the informed consent document, to give consent voluntarily or to complete the study tasks.
• Participation in another clinical study involving an investigational product within 1 month before study entry.

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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336 participants in 2 patient groups

Conventional endoscopic prostatic surgery

Experimental group

Description:

Endoscopic resection of prostate.

Treatment:

Procedure: Conventional endoscopic prostatic surgery

Partial surgery preserving the prostatic apex

Experimental group

Description:

Patients randomised to the partial endoscopic resection group will undergo surgical treatment that preserves the apex area of the prostate (tissue located 1 cm around the veru montanum).

Treatment:

Procedure: Partial surgery preserving the prostatic apex