EDITORIAL COMMENT

Abstract

How important really is it for a man to preserve his antegrade ejaculation following a benign prostatic hyperplasia (BPH) procedure? How many men really care? These are 2 questions that have yet to be published on in our urologic peer reviewed literature. Prior to the advent of medical management for BPH this was a nonissue. The only treatments were open simple prostatectomy or transurethral resection of the prostate (TURP), both of which produced a very high rates of ejaculatory dysfunction and was just expected to occur for patients postprocedure. Once medical management became available, the preservation of ejaculatory function was significantly improved for BPH treatments, but some drugs still had a 30% dysfunction rate. 1 Kaplan S. Side effects of alpha-blocker use: retrograde ejaculation. Rev Urol. 2009; 11: 14-18 PubMed Google Scholar In the recent past, newer minimally invasive treatments have been developed which attempt to limit this dysfunction. The Rezum, Urolift, and Aquaablation systems all have published articles in our urologic peer reviewed literature that have very low rates of ejaculatory dysfunction. 2 McVary KT Gange SN Gittelman MC et al. Erectile and Ejaculatory Function Preserved with Convective Water Vapor Energy. Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia: Randomized Controlled Study. J Sex Med. 2016; 13: 924-933 Abstract Full Text Full Text PDF PubMed Scopus (71) Google Scholar , 3 McVary KT Gange SN Shore ND et al. Treatment of LUTS secondary to BPH while preserving sexual function: randomized controlled study of prostatic urethral lift. J Sex Med. 2014; 11: 279-287 Abstract Full Text Full Text PDF PubMed Scopus (76) Google Scholar , 4 Gilling P Kaplan Steven A. Gul Zeynup Te Alexis E. et al. Two-year outcomes after aquablation compared to TURP: efficacy and ejaculatory improvement sustained. Adv Ther. 2019; 36 (Jun): 1326-1336 Google Scholar