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Related Concept Videos

Male Sexual Response: Erection & Ejaculation01:17

Male Sexual Response: Erection & Ejaculation

Sexual stimulation can take various forms, such as physical touch and visual or auditory cues. When this happens, the parasympathetic reflex in the sacral portion of the spinal cord is activated. This reflex stimulates the release of nitric oxide (NO), which then dilates the arterioles in the penis, increasing blood flow to the erectile tissues - the corpora cavernosa and corpus spongiosum.
The blood filling the erectile tissues compresses the veins, which helps to prevent blood from leaving...

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Modified HoLEP technique: does it preserve ejaculation?

Lautaro German Spezzi Roncero1, Guillermo Montelli Yanzi2, Christian Cristallo2

  • 1Department of Urology, Endourology and Benign Prostatic Hyperplasia Sector, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, C1199, Buenos Aires, Argentina. lautarospezzi@gmail.com.

World Journal of Urology
|June 29, 2026
PubMed
Summary
This summary is machine-generated.

This study found that preserving peri-verumontanum tissue during Holmium Laser Enucleation of the Prostate (HoLEP) did not improve antegrade ejaculation rates. Both standard and modified HoLEP techniques effectively improved lower urinary tract symptoms.

Keywords:
AdenomaBenign prostatic hyperplasiaEjaculationHolmium laserProstatic

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Published on: March 15, 2024

Area of Science:

  • Urology
  • Surgical Techniques
  • Men's Health

Background:

  • Benign prostatic hyperplasia (BPH) affects a significant portion of the aging male population.
  • Holmium Laser Enucleation of the Prostate (HoLEP) is an effective surgical treatment for BPH.
  • Antegrade ejaculation is a concern for many patients undergoing HoLEP.

Purpose of the Study:

  • To evaluate if a modified HoLEP technique, preserving peri-verumontanum tissue, can better preserve antegrade ejaculation.
  • To assess postoperative prostatic symptoms and patient-reported discomfort related to ejaculatory function after HoLEP.

Main Methods:

  • A prospective randomized study compared standard HoLEP with a modified HoLEP technique (preserving 1 cm of peri-verumontanum tissue).
  • 75 patients were enrolled and followed for 6 months post-surgery.
  • Validated questionnaires (IPSS, MSHQ-EjD Short Form) assessed symptoms and ejaculatory function.

Main Results:

  • No significant difference in the change of International Prostate Symptom Score (IPSS) between groups (p=0.835).
  • No significant difference in the change of ejaculatory function scores between groups (p=0.619).
  • A majority of patients (66.6%) reported minimal bother from ejaculatory function post-surgery.

Conclusions:

  • Preserving peri-verumontanum tissue during HoLEP does not significantly improve antegrade ejaculation rates compared to the standard technique.
  • Both surgical approaches led to significant improvements in lower urinary tract symptoms.
  • Patient-reported ejaculatory function bother varied post-surgery, with most reporting little to no discomfort.