Study on the effect of completely preserving the ejaculatory duct during prostatectomy on reducing postoperative retrograde ejaculation in benign prostatic hyperplasia patients

Introduction
Preserving the sexual function of benign prostatic hyperplasia (BPH) patients and reducing the incidence of postoperative retrograde ejaculation are critical for BPH patients with sexual needs.

Aim
To explore the effect of complete preservation of the seminal tract during transurethral prostatectomy (TURP) on reducing retrograde ejaculation in BPH patients.

Material and methods
BPH patients meeting the inclusion criteria were randomly divided into the Control group (traditional TURP) and the Experimental group (complete reserved ejaculatory duct) in a ratio of 1 : 1. Finally, data of 64 BPH patients – 34 in the Control group and 30 in the Experimental group – were analyzed. We measured the preoperative and postoperative maximum urinary flow rate (Qmax), International Prostate Symptom Score (IPSS), Quality of Life (QOL) score, semen volume, and ejaculation function.

Results
Compared with pre-operation values, patients in the two groups exhibited increased Qmax and decreased IPSS and QOL scores after the operation. However, there was no significant difference in Qmax, IPSS, or QOL between the Control and Experimental groups after the operation. The two groups of patients had a significant reduction in postoperative ejaculation. Compared with the Control group, the semen volume of patients was higher, and the incidence of retrograde ejaculation was lower in the Experimental group.

Conclusions
Prostatectomy with complete preservation of the seminal tract is not different from conventional electrosurgical resection in improving urination symptoms, while the incidence of retrograde ejaculation is significantly lower.