(O-09) Frequency of retrograde ejaculation after surgery for benign prostatic enlargement and its impact on perceived ejaculatory quality

Abstract Introduction and Objectives Retrograde ejaculation (RE) is a common complication after surgery for benign prostatic enlargement (BPE), particularly in techniques that affect the bladder neck. The aim of this study was to describe the frequency of postoperative RE and its impact on patient-perceived ejaculatory quality. Materials and Methods We conducted a prospective longitudinal study in men undergoing surgery for BPE between March 2019 and February 2025 who remained sexually active postoperatively. Clinical variables, type of surgery, and outcomes at 3, 6, and 12 months were collected. Validated questionnaires (IPSS, SHIM) were applied. Statistical analysis included descriptive statistics and Mann–Whitney U, chi-square, or Fisher’s exact tests (p < 0.05). Results A total of 1090 patients underwent surgery during the study period; 34 sexually active, and 994 did not provide sexual health information. Thus, 62 sexually active patients were included. RE was reported in 71% (n = 44) at some point during follow-up: 62.9% at 3 months, 76.9% at 6 months, and 20% at 12 months. The techniques most frequently associated with RE were photoselective vaporization with green laser (61.4%) and holmium laser enucleation (25%). At 6 and 12 months, 50% of patients with RE reported being satisfied or indifferent regarding ejaculatory quality. Most reported no alterations in orgasm. Conclusions RE is common after surgery for BPE, although its incidence decreases over time. Perception of ejaculatory quality tends to remain favorable, highlighting the importance of counseling patients and considering their sexual priorities when choosing a surgical approach. Postoperative outcomes. Financing No conflict.