title: Ejaculation-preserving transurethral resection of prostate and bladder neck: short- and long-term results of a new innovative resection technique.
abstract: BACKGROUND
  Loss of antegrade ejaculation is a risk with conventional resection of the prostate (transurethral resection of the prostate [TURP]). The aim of this study was to determine the short- and long-term preservation of antegrade ejaculation and functional results with the novel ejaculation-preserving TURP (epTURP).
  
  
  METHODS
  Prospective evaluation of 89 consecutive patients with bladder outlet obstructions aged 27 to 78 years, enrolled from June 2001 to January 2005. Endpoints were change in objective (uroflowmetry, postvoid residual [PVR]), and subjective (International Prostate Symptoms Score [IPSS], Life Quality Index [LQI]; International Index of Erectile Function-5 [IIEF-5+] with two additional questions) measures of function. All patients received follow-up examinations at 3 and ≥60 months.
  
  
  RESULTS
  Overall, 87 and 63 patients were evaluated after 3 and 60 months, respectively. Antegrade ejaculation was preserved in 79 of 87 (90.8%) patients at 3 months. Significant improvements in maximum flow rate (+14.3 mL/s), micturition volume (+71.6 mL), and PVR (-59 mL; p≤0.002 for all) were observed at 3 months. Micturition symptoms, as measured by IPSS and LQI, were also significantly reduced (mean change of 18.3 and 2.9, respectively; p<0.001). Improvements were maintained at 60 months. No serious adverse events were reported. Eight (12.7%) patients received a second epTURP due to the development of bladder neck scar tissue during long-term follow-up.
  
  
  CONCLUSIONS
  Antegrade ejaculation was preserved with the use of epTURP with excellent outcome. Observed symptomatic and functional outcomes were comparable with conventional TURP. The results from this study underline the necessity of reviewing the old concept of ejaculation physiology.
authors: 1 Department of Urology, Academic Teaching Hospital of University of Saarland , Städtisches Klinikum Neunkirchen, Neunkirchen, Germany .
authors: Saladin Helmut
authors: SH
authors: Alloussi
authors: Christoph
authors: C
authors: Lang
authors: Robert
authors: R
authors: Eichel
authors: Schahnaz
authors: S
authors: Alloussi
mesh_terms: D000328:Adult; D000368:Aged; D004542:Ejaculation; D006801:Humans; D008297:Male; D008875:Middle Aged; D059351:Organ Sparing Treatments / Q000009:adverse effects / Q000379:methods; D011446:Prospective Studies; D011788:Quality of Life; D020728:Transurethral Resection of Prostate / Q000009:adverse effects / Q000379:methods*; D001748:Urinary Bladder Neck Obstruction / Q000453:epidemiology* / Q000503:physiopathology* / Q000601:surgery*; D014554:Urination