Ejaculation-Preserving Transurethral Resection of the Prostate: A Randomized Controlled Trial.

Abstract

Objective: To evaluate the efficacy of preserving urethral mucosa around verumontanum in all directions and at the prostatic apex on antegrade ejaculation preservation and early postoperative continence in patients undergoing transurethral resection of the prostate (TURP). Materials and Methods: A randomized controlled trial was conducted in our tertiary center on patients scheduled for TURP. Patients were randomly allocated into two equal groups. Group A represented the control group who underwent conventional TURP, while Group B represented the ejaculation-sparing TURP. Patients were followed up for 3 months postoperatively to evaluate the voiding parameters and the preservation of antegrade ejaculation. Results: A total of 106 patients were evaluated in our study. Both groups were comparable regarding improvement in voiding parameters. Antegrade ejaculation was preserved in 44 patients (83%) of Group B compared with 10 patients (18.9%) in Group A with a highly statistically significant difference (p < 0.001). Early postoperative urge urinary incontinence was lower in group B (5.7%) compared with (20.8%) in group A, with a statistically significant difference (p = 0.02). Other perioperative parameters were compared between both groups. Conclusion: The ejaculation-sparing technique adopted in our study showed a promising result for preserving antegrade ejaculation following TURP with a success rate of 83%. Additionally, there was a lower incidence of early postoperative urge urinary incontinence.