Antegrade ejaculation following transurethral laser ablation of the prostate

A major drawback for many sexually active men who undergo a prostatectomy for benign prostatic hyperplasia, either via a transurethral resection or an open procedure, is the high incidence of retrograde ejaculation. Transurethral laser ablation of the prostate (TULAP) is a minimally invasive alternative to these procedures for prostatic outlet obstruction. We retrospectively reviewed 37 patients who underwent the TULAP procedure. Our data revealed that in addition to a significant improvement in voiding symptoms, 92% of sexually active patients retained both potency and antegrade ejaculation postoperatively. We conclude that this procedure is a viable alternative to transurethral prostatectomy, especially for the men who wish to remain sexually potent with antegrade ejaculation. A rationale for the mechanism of preservation of ejaculatory function is discussed.