The Effect of Transurethral Resection of the Prostate while Preserving Urethral Mucosa at the Prostatic Apex on Retrograde Ejaculation and Postoperative Urine Continence in Patients with BPH

Abstract Objective To evaluate the effect of transurethral resection of the prostate while preserving Urethral Mucosa at the Prostatic Apex on retrograde ejaculation and postoperative urine continence in patients with BPH after surgery. Patients and Methods A total of 106 participants were enrolled in the study, after obtaining informed consent, patients were randomized into 2 groups with a 1:1 ratio using sealed envelopes that was prepared by the department’s ethical committee, each group with 53 cases. group 1 represent traditional TURP, while group 2 represents TURP with preserved urethral mucosa at the prostatic apex. Results there was no statistically significant difference between control and observation group regarding age and pre-operative IPSS, Q-max, PVRU, prostate size and ejaculation also There was no statistically significant difference between control and observation group regarding post- operative IPSS, Q-max, PVRU, but shows that there is a statistically significant difference between control and observation group regarding the post operative ejaculation with 83% of EP-TURP patients maintained normal ejaculation post-operatively versus only 19% with traditional TURP (p < 0.001). There was a statistically significant difference between control and observation group regarding early post-operative continence, EP-TURP also resulted in significantly better urinary continence outcomes (94.3% vs 79.2%, p = 0.022) Conclusion Our randomized study demonstrated that ejaculation-preserving transurethral resection of the prostate (EP-TURP) preserving antegrade ejaculation and reducing urinary incontinence in early post operative, also reducing bladder outlet symptoms like dysuria, urgency and frequency with no difference in post operative IPSS, Q max and PVRU