Ejaculation-Preserving Transurethral Resection of the Prostate: A Randomized Controlled Trial

Area of Science:

• Urology
• Surgical Innovation
• Men's Health

Background:

• Transurethral resection of the prostate (TURP) is a common procedure for benign prostatic hyperplasia.
• Conventional TURP can lead to complications such as retrograde ejaculation and urinary incontinence.
• Preserving specific anatomical structures during TURP is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of an ejaculation-sparing TURP technique.
• To assess the impact of preserving urethral mucosa around the verumontanum and prostatic apex.
• To determine the effects on antegrade ejaculation and early postoperative continence.

Main Methods:

• A randomized controlled trial involving 106 patients undergoing TURP.
• Patients were divided into two groups: conventional TURP (Group A) and ejaculation-sparing TURP (Group B).
• Postoperative follow-up for 3 months evaluated voiding parameters, antegrade ejaculation, and urinary incontinence.

Main Results:

• Antegrade ejaculation was preserved in 83% of patients in the ejaculation-sparing group versus 18.9% in the conventional group (p < 0.001).
• Early postoperative urge urinary incontinence was significantly lower in the ejaculation-sparing group (5.7%) compared to the control group (20.8%) (p = 0.02).
• Both techniques showed comparable improvements in voiding parameters.

Conclusions:

• The ejaculation-sparing TURP technique demonstrates a high success rate (83%) in preserving antegrade ejaculation.
• This technique also results in a lower incidence of early postoperative urge urinary incontinence.
• Preserving urethral mucosa during TURP offers significant benefits for sexual function and continence.