Correlation between intravesical prostatic protrusion and ejaculatory dysfunction after tamsulosin treatment in men with BPH

To evaluate the correlation between prostate morphological measurements and changes in ejaculatory function during short-term tamsulosin therapy in men with benign prostatic hyperplasia (BPH). This prospective study included 214 sexually active men with moderate-to-severe lower urinary tract symptoms (LUTS) who received tamsulosin 0.4 mg/day for eight weeks. Patients with prior treatment for BPH or pre-existing sexual dysfunction were excluded. Symptom severity and ejaculatory function were evaluated using the International Prostate Symptom Score (IPSS) and the Male Sexual Health Questionnaire–Ejaculatory Dysfunction Short Form (MSHQ-EjD-SF). Prostate morphological measurements, including overall dimensions and intravesical prostatic protrusion (IPP), were obtained by transabdominal ultrasonography. Correlations between changes in MSHQ-EjD scores (ΔMSHQ-EjD) and clinical or anatomical variables were assessed using Spearman’s rank coefficients. After eight weeks of treatment, the median IPSS significantly decreased from 18 to 14 (p < 0.001) and Qmax increased from 9.2 to 14.0 mL/s (p < 0.001). The median MSHQ-EjD-SF score declined from 11 to 7 (p < 0.001), while higher ejaculatory bother scores were observed after treatment. ΔMSHQ-EjD was negatively correlated with IPP (ρ = −0.386), prostate length (ρ = −0.250), and age (ρ = −0.334) (all p < 0.01). Patients with IPP > 10 mm showed a less pronounced decline in ejaculatory function compared with lower IPP grades (p < 0.001). Tamsulosin improved urinary symptoms but was associated with a decline in ejaculatory function. Prostate morphological characteristics, particularly IPP > 10 mm and longer prostate length, were associated with a less pronounced decline in ejaculatory function. Although these correlations were modest, the findings may help contextualize the relationship between prostate anatomy and tamsulosin-related ejaculatory changes.