A Study on Preservation of Normal Ejaculatory Function After Transurethral Resection in Benign Prostatic Hypertrophy

Kim, Young Soo; Kim, Se Kyong

Abstract

It is well known fact that dry ejaculation is commonly found following simple prostatectomy including transurethral resection of hypertrophied prostate. To preserve normal ejaculatory function following transurethral resection in benign prostatic hypertrophy patients, we have modified the technique of transurethral resection to give less injury to the bladder neck, ejaculatory duct, urethral mucosa and branches of nerves by preserving smaller lateral lobe in cases one lateral lobe is much smaller than the other, or preserving lower one third of a lateral lobe in cases of big bilateral lobes, resecting all other lobes(B-type), and this technique was applied in 66 cases. Control group was 24 cases in which all lobes were resected like ordinary transurethral resection technique(A-type). Ninety cases, ranged in age from 42 to 79 years (mean; 68.0 years), were followed by interviewing with the questionaionaires concerning sexual desire, erection, vaginal penetration, orgasm and ejaculation. Loss of ejaculatory function was noted preoperatively in 4 cases of the group A and in 6 cases of the group B. Four out of 60 cases had dry ejaculation in the group in which B-type of transurethral resection of prostate was applied, while 15 out of 20 cases had dry ejaculation or anejaculation in the group A. There were 3 patients who had undergone B-type operation first and one to four years later A-type operation was also performed, and they complained of no ejaculatory disturbance after B-type operation. However, dry ejaculation did occur after A-type operation in all three patients. All 90 cases were able to achieve an erection with sexual desire preoperatively and postoperatively Seven cases of decreased orgasm were noted in the group B, while 8 cases complained of decreased orgasm in the group A. Judging from above results this modified technique of transurethral resection of prostate is a useful method to preserve normal ejaculatory function.