AUTHOR REPLY

Abstract

We agree that preservation of ejaculation is viewed positively by patients and their partners. For many men, this factor alone helps them determine which of the myriad therapies for benign prostatic hyperplasia they ultimately select. Dr. Ulchaker is spot on with his observation that many benign prostatic hyperplasia therapies can result in ejaculatory dysfunction with varying rates among medical, minimally invasive technologies and surgery. However, we maintain that preservation of tissue near and around the verumontanum is key to ensuing ejaculatory preservation. Although some alpha blockers may result in ejaculatory dysfunction, this is more likely secondary to anejaculation rather than retrograde ejaculation. Furthermore, Rezum water vapor therapy does not eliminate tissue near the veru as in a resection and/or vaporization technique. Rather, it creates pockets of coagulation necrosis. Finally, and of interest, the Aquablation technique by choice and design attempts to preserve ejaculation by modifying treatment patterns near the veru. We believe that maintenance of ejaculation will be less likely related to which technology is used and more due to tissue preservation near the verumontanum. Time will tell!