Ejaculation-preserving prostate resection

Reasons why ejaculation is no longer possible after certain prostate operations (TURP)

The prostate, also known as the prostate gland, is a chestnut-sized organ in the center of the male urinary and sexual tract. It lies below the bladder and surrounds the urethra. The prostate consists mainly of glandular tissue, which produces prostate secretions. This makes up the majority of seminal fluid.

In the case of benign prostate enlargement, the inner tissue of the prostate grows and then presses on the urethra and bladder. As a result, the patient may have difficulty emptying the bladder and even suffer from incontinence (involuntary loss of urine).

During prostate surgery - such as the TURP procedure or using the Da Vinci method to treat a benignly enlarged prostate - the inner glandular tissue is usually removed completely. The prostate can then no longer produce secretions - the ability to ejaculate is lost after prostate surgery. This is known as retrograde ejaculation after TURP (also called dry ejaculation after TURP), where semen flows backwards into the bladder instead of being expelled normally.

Even with a radical prostatectomy, i.e. the complete removal of the prostate to treat prostate cancer, the ability to ejaculate is lost after prostate surgery.

Requirements to be able to maintain ejaculation after prostate surgery

Whether a man is suitable for a sperm-retention prostate operation must be clarified in detail by his doctor before the procedure and discussed in detail. In a very advanced stage of prostate enlargement or if complications have already occurred, this technique is not recommended.

Ejaculation-preserving prostate resection – procedure and special features

Ejaculation-preserving prostate resection can be performed under general anesthesia or spinal anesthesia. During the procedure, an optical instrument (resectoscope) and an electric snare are inserted via the urethra (transurethrally). The snare is used to remove the enlarged tissue inside the prostate. During the scraping procedure, not all of the inner tissue is removed, but a part near the seminal mound is retained. Following the operation, a permanent catheter with an irrigation fluid is inserted. This is used to flush the bladder and is removed three to five days later before the patient is discharged from hospital. Bladder emptying is then possible again without interruption. Ejaculation after TURP is possible again a few weeks after the operation – a key advantage of this technique compared to conventional methods, where TURP and ejaculation are generally incompatible. Beyond ejaculation, many patients also wonder: how soon after TURP surgery can you have sex? In most cases, sexual activity can be resumed approximately four to six weeks after the procedure, once healing is complete.

The sperm ejaculation-preserving surgical technique of ejaculation-protective transurethral prostate resection requires detailed knowledge of the mechanisms underlying ejaculation. The method is based on the preservation of certain parts of the prostate tissue above and next to the seminal mound. This allows the prostate to continue to produce the secretion that is important for ejaculation. Studies show that this technique preserves the ability to ejaculate in nine out of ten men who have undergone surgery.