Comparison of Transurethral Resection of the Prostate (TURP) with 0.5-cm Tissue Preservation Proximal to the Verumontanum and Standard TURP in terms of Postoperative Ejaculation Disorders
Urology Journal,
Vol. 22 No. 01 (2025),
12 January 2025
,
Page 50-55
https://doi.org/10.22037/uj.v21i.8074
Abstract
Purpose: To compare postoperative ejaculation disorders (EjDs) between transurethral resection of the prostate (TURP) with 0.5-cm tissue preservation proximal to the verumontanum and the standard TURP procedure.
Materials and Methods: Between February 2016 and August 2020, 226 patients who underwent TURP for symptomatic benign prostatic hyperplasia were retrospectively screened. The patients were analyzed in two groups: In Group A (n = 106), TURP was performed by preserving 0.5-cm tissue proximal to the verumontanum, while in Group B (n = 120), standard TURP was performed. The postoperative voiding functions and EjD rates were compared.
Results: Similar findings were observed in the international prostate symptom score, health-related quality of life score, maximum urine flow rate, and post-void residual volume in both groups. In Group A, ejaculation was preserved in 55 (51.9%) patients, the ejaculation volume was decreased in 13 (12.3%), and EjD developed in 38 (35.8%). In Group B, ejaculation was preserved in 16 (13.8%) patients, the ejaculation volume decreased in 15 (12.5%), and EjD developed in 89 (74.2%).
Conclusion: The ejaculatory function of patients can be maintained in the TURP procedure through the preservation of 0.5-cm tissue from the proximal verumontanum. The modification of TURP can further reduce the risks and undesirable effects of the procedure. The implementation of novel surgical technique modifications and technological developments can potentially decrease complication rates. This approach will also eliminate the assumption that the development of EjD is inevitable after prostate surgery.
- bening prostat hyperplasia, ejaculation, , postoperative ejaculation disorders, transurethral prostate resection
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References
Abrams P, Chapple C, Khoury S, Roehrborn C, De la Rosette J. Evaluation and treatment of lower urinary tract symptoms in older men. J Urol. 2009;181:1779-87.
Epstein RS, Deverka PA, Chute CG, et al. Validation of a new quality of life questionnaire for benign prostatic hyperplasia. J Clin Epidemiol. 1992;45:1431-45.
De Nunzio C, Roehrborn CG, Andersson K-E, McVary KT. Erectile dysfunction and lower urinary tract symptoms. Eur Urol Focus. 2017;3:352-63.
Frieben RW, Lin H-C, Hinh PP, Berardinelli F, Canfield SE, Wang R. The impact of minimally invasive surgeries for the treatment of symptomatic benign prostatic hyperplasia on male sexual function: a systematic review. Asian J Androl. 2010;12:500.
Cornu J-N, Ahyai S, Bachmann A, et al. A systematic review and meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic obstruction: an update. Eur Urol. 2015;67:1066-96.
Hashmat AI, Hakim LS. Antegrade ejaculation following transurethral laser ablation of the prostate. J Androl. 1994;15:28S-30S.
Malde S, Umbach R, Wheeler JR, et al. A systematic review of patients’ values, preferences, and expectations for the diagnosis and treatment of male lower urinary tract symptoms. Eur Urol Focus. 2021;79:796-809.
Sokolakis I, Pyrgidis N, Russo GI, Sountoulides P, Hatzichristodoulou G. Preserving ejaculation: a guide through the landscape of interventional and surgical options for benign prostatic obstruction. Eur Urol Focus. 2022;8:380-3.
Ronzoni G DVM. Preservation of anterograde ejaculation after transurethral resection of both the prostate and bladder neck. Br J Urol. 1998;81:830-3.
Alloussi SH, Lang C, Eichel R, Alloussi S. Ejaculation-preserving transurethral resection of prostate and bladder neck: short-and long-term results of a new innovative resection technique. J Endourol. 2014;28:84-9.
Lebdai S, Chevrot A, Doizi S, et al. Do patients have to choose between ejaculation and miction? A systematic review about ejaculation preservation technics for benign prostatic obstruction surgical treatment. World J Urol. 2019;37:299-308.
Hammadeh M, Madaan S, Singh M, Philp T. A 3‐year follow‐up of a prospective randomized trial comparing transurethral electrovaporization of the prostate with standard transurethral prostatectomy. BJU Int. 2000;86:648-51.
Pavone C, Abbadessa D, Scaduto G, et al. Sexual dysfunctions after transurethral resection of the prostate (TURP): evidence from a retrospective study on 264 patients. Arch Ital Urol Androl. 2015;87:8-13.
Elshazly M, Sultan S, Shaban M, Zanaty F. Evaluation of a novel technique of bladder neck and supramontanal sparing ejaculatory preserving transurethral prostatectomy. World J Urol. 2021;39:4215-9.
Mathangasinghe Y, Samaranayake UM, Dolapihilla BN, Anthony DJ, Malalasekera AP. Morphology of ejaculatory ducts: A systematic review. Clin Anat. 2020;33:1164-75.
Malalasekera AP, Sivasuganthan K, Sarangan S, et al. Morphological variations of the human ejaculatory ducts in relation to the prostatic urethra. Clin Anat. 2018;31:456-61.
Gil‐Vernet Jr J, Alvarez‐Vijande R, Gil‐Vernet A, Gil‐Vernet J. Ejaculation in men: a dynamic endorectal ultrasonographical study. Br J Urol. 1994;73:442-8.
Alwaal A, Breyer BN, Lue TF. Normal male sexual function: emphasis on orgasm and ejaculation. Fertil Steril. 2015;104:1051-60.
McMahon CG, Abdo C, Incrocci L, et al. Disorders of orgasm and ejaculation in men. J Sex Med. 2004;1:58-65.
Kini M TA, Kashanian JA, Kaplan S, Chughtai B. Ejaculatory hood-sparing photoselective vaporization of the prostate vs bipolar button plasma vaporization of the prostate in the surgical management of benign prostatic hyperplasia. J Endourol. 2020;34:322-9.
Hollingsworth JM, Wilt TJ. Lower urinary tract symptoms in men. BMJ. 2014;349.
Carmignani L, Bozzini G, Macchi A, Maruccia S, Picozzi S, Casellato S. Sexual outcome of patients undergoing thulium laser enucleation of the prostate for benign prostatic hyperplasia. Asian J Androl. 2015;17:802.
Cacciamani GE, Cuhna F, Tafuri A, et al. Anterograde ejaculation preservation after endoscopic treatments in patients with bladder outlet obstruction: systematic review and pooled-analysis of randomized clinical trials. Minerva Urol Nefrol. 2019;71:427-34.
Sturch P, Woo HH, McNicholas T, Muir G. Ejaculatory dysfunction after treatment for lower urinary tract symptoms: retrograde ejaculation or retrograde thinking? BJU Int. 2015;115:186-7.
Sarier M, Duman I, Kilic S, et al. Comparative results of transurethral incision with transurethral resection of the prostate in renal transplant recipients with benign prostate hyperplasia. Urol J. 2018;15:209-13.
Soderdahl DW, Knight RW, Hansberry K. Erectile dysfunction following transurethral resection of the prostate. J Urol. 1996;156:1354-6.
Kaplan SA. Side effects of α-blocker use: retrograde ejaculation. Rev Urol. 2009;11:S14.
Marra G, Sturch P, Oderda M, Tabatabaei S, Muir G, Gontero P. Systematic review of lower urinary tract symptoms/benign prostatic hyperplasia surgical treatments on men's ejaculatory function: Time for a bespoke approach? Int J Urol. 2016;23:22-35.
Kahokehr AA, Gilling PJ. Recent advances in the understanding of male lower urinary tract symptoms (LUTS). F1000Res. 2016;5.
McVary KT, Gange SN, Shore ND, et al. Treatment of LUTS secondary to BPH while preserving sexual function: randomized controlled study of prostatic urethral lift. J Sex Med. 2014;11:279-87.
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