World Journal of Urology

, Volume 37, Issue 2, pp 299–308 | Cite as

Do patients have to choose between ejaculation and miction? A systematic review about ejaculation preservation technics for benign prostatic obstruction surgical treatment

  • Souhil LebdaiEmail author
  • Armand Chevrot
  • Steeve Doizi
  • Benjamin Pradere
  • Nicolas Barry Delongchamps
  • Amine Benchikh
  • Jean Nicolas Cornu
  • Emmanuel Della Negra
  • Marc Fourmarier
  • Vincent Misraï
  • Pierre Etienne Theveniaud
  • Aurélien Descazeaud
  • Grégoire Robert
  • For the CTMH-AFU group
Invited Review



Ejaculatory dysfunction is the most common side effect related to surgical treatment of benign prostatic obstruction (BPO). Nowadays, modified surgical techniques and non-ablative techniques have emerged with the aim of preserving antegrade ejaculation. Our objective was to conduce a systematic review of the literature regarding efficacy on ejaculatory preservation of modified endoscopic surgical techniques, and mini-invasive non-ablatives techniques for BPO management.


A systematic review of the literature was carried out on the PubMed database using the following MESH terms: “Prostatic Hyperplasia/surgery” and “Ejaculation”, in combination with the following keywords: “ejaculation preservation”, “photoselective vaporization of the prostate”, “photoselective vapo-enucleation of the prostate”, “holmium laser enucleation of the prostate”, “thulium laser”, “prostatic artery embolization”, “urolift”, “rezum”, and “aquablation”.


The ejaculation preservation rate of modified-TURP ranged from 66 to 91%. The ejaculation preservation rate of modified-prostate photo-vaporization ranged from 87 to 96%. The only high level of evidence studies available compared prostatic urethral lift (PUL) and aquablation versus regular TURP in prospective randomized-controlled trials. The ejaculation preservation rate of either PUL or aquablation compared to regular TURP was 100 and 90 versus 34%, respectively.


Non-ablative therapies and modified endoscopic surgical techniques seemed to be reasonable options for patients eager to preserve their ejaculatory functions.


Benign prostatic hyperplasia Ejaculation preservation Endoscopic surgery Ejaculatory dysfunction Lower urinary tract symptoms Retrograde ejaculation 


Author contributions

SL: project development, data collection, and manuscript writing. AC: project development, data collection, and manuscript writing. NBD, AB, JNC, AD, SD, MF, BP, VM, GR, and PET: project development and reviewing.

Compliance with ethical standards

Conflict of interest

Armand Chevrot: none. Nicolas Barry Delongchamps: none. Amin Benchikh: none. Jean Nicolas Cornu: none. Aurélien Descazeaud: consultant for Bouchara Recordati, Pierre Fabre Medicament, Lilly, investigator pour EDAP TMS. Steeve Doizi: none. Marc Fourmarier: consultant for GSK and EDAP TMS. Souhil Lebdai: none. Benjamin Pradère: none. Vincent Misraï: none. Gregoire Robert: consultant for Pierre Fabre Medicament, investigator for EDAP TMS. Pierre Etienne Theveniaud: none.

Research involving human participants and/or animals

Not applicable.

Informed consent

Not applicable.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Souhil Lebdai
    • 1
    Email author
  • Armand Chevrot
    • 2
  • Steeve Doizi
    • 3
  • Benjamin Pradere
    • 4
  • Nicolas Barry Delongchamps
    • 5
  • Amine Benchikh
    • 6
  • Jean Nicolas Cornu
    • 7
  • Emmanuel Della Negra
    • 8
  • Marc Fourmarier
    • 9
  • Vincent Misraï
    • 10
  • Pierre Etienne Theveniaud
    • 11
  • Aurélien Descazeaud
    • 12
  • Grégoire Robert
    • 13
  • For the CTMH-AFU group
  1. 1.Urology DepartmentUniversity Hospital of Angers, CHU AngersAngers Cedex 9France
  2. 2.Urology DepartmentUniversity Hospital of NimesNîmesFrance
  3. 3.Urology DepartmentHôpital Européen Georges PompidouParisFrance
  4. 4.Urology DepartmentUniversity Hospital of ToursToursFrance
  5. 5.Urology DepartmentUniversity Hospital of CochinParisFrance
  6. 6.Urology DepartmentClinique les MartinetsVersaillesFrance
  7. 7.Urology DepartmentUniversity Hospital of RouenRouenFrance
  8. 8.Urology DepartmentHôpital des Côtes d’ArmorSaint BrieucFrance
  9. 9.Urology DepartmentHospital of Aix en ProvenceAix en ProvenceFrance
  10. 10.Urology DepartmentClinique PasteurToulouseFrance
  11. 11.Urology DepartmentSaint Joseph HospitalParisFrance
  12. 12.Urology DepartmentUniversity Hospital of LimogesLimogesFrance
  13. 13.Urology DepartmentUniversity Hospital of BordeauxBordeauxFrance

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