Surgical correction of post-operative retrograde ejaculation

Retrograde ejaculation is a known complication of bladder neck surgery. Revision of a bilharzial bladder neck obstruction accentuates the incidence of this complication. Some of the difficulties in the surgical correction of retrograde ejaculation are directly related to pathological changes caused by bilharziasis. In this study a new length of premontanal urethra is formed using the trigonal urothelium and the trigonal muscles with their intact sympathetic innervation to correct retrograde ejaculation following bladder neck surgery. Normal (antegrade) ejaculation was restored in four of five men using this procedure. The physiological basis of the procedure is discussed.