Transurethral resection of the prostate with preservation of the bladder neck decreases postoperative retrograde ejaculation.

Introduction: Even though transurethral resection of the prostate (TURP) is the standard surgical treatment for benign prostatic hyperplasia (BPH), there is a high rate of postoperative retrograde ejaculation.

Aim: To evaluate the effectiveness of TURP with preservation of the bladder neck in comparison with that of standard TURP.

Material and methods: This is a retrospective study. 137 men with BPH were divided into two groups: TURP with preservation of the bladder neck and standard TURP were performed respectively in group A and group B. The patients were evaluated preoperatively and at 3, 6 and 12 months after surgery by International Prostate Symptom Score (IPSS), health-related quality of life (HRQL) score, maximum urinary flow rate (Qmax), postvoid residual urine volume (PVR) and the rate of complications including retrograde ejaculation.

Results: There was no statistically significant difference between groups in terms of the operative duration, catheterization period, hemoglobin decrease, and hospital stay. At the 3-month follow-up, the rates of incontinence and retrograde ejaculation in group A were lower than those in group B. At the 6- and 12-month follow-ups, the difference in the frequency of retrograde ejaculation remained constantly stable whereas the incontinence rates were similar in both groups. The IPSS, HRQL score, Qmax, PVR and the rate of complications including hematuria, clot retention, urinary tract infection, urethral stricture, and bladder neck contracture evaluated at 3, 6 and 12 months also displayed a very similar response in the two groups.

Conclusions: Comparable with standard TURP, TURP with preservation of the bladder neck appears to provide a satisfactory clinical outcome in decreasing early postoperative incontinence and lowering the rate of retrograde ejaculation.