None listed
Conditions
Brief summary
When men have surgery for a blocked prostate (called TURP), they often notice that they no longer ejaculate during orgasm. This is commonly assumed to be because semen travels backwards into the bladder instead of forwards, a condition called retrograde ejaculation. However, it is possible that the cause is actually that semen is not produced at all during orgasm (anejaculation). These two conditions look the same from the outside but have different implications, particularly for men who wish to have children in the future. This study will use a simple urine test after orgasm to objectively determine which of these two conditions is occurring in men who have had TURP. It will also assess whether this urine test is practical enough to be used routinely in clinical care.
Interventions
This study observes ejaculatory outcomes in men undergoing transurethral resection of the prostate (TURP) for benign prostatic hyperplasia. Participants undergo post-ejaculatory urinalysis (PEU) at two timepoints: pre-operatively (baseline) and at six weeks post-operatively. PEU involves the participant voiding a first-stream urine sample of at least 30ml within one hour of orgasm, delivered to an accredited external pathology laboratory within 3 hours of collection. Samples are assessed for spe
This study observes ejaculatory outcomes in men undergoing transurethral resection of the prostate (TURP) for benign prostatic hyperplasia. Participants undergo post-ejaculatory urinalysis (PEU) at two timepoints: pre-operatively (baseline) and at six weeks post-operatively. PEU involves the participant voiding a first-stream urine sample of at least 30ml within one hour of orgasm, delivered to an accredited external pathology laboratory within 3 hours of collection. Samples are assessed for sperm count and seminal biochemical markers (if sperm and seminal biochemical markers are present, this indicates retrograde ejaculation). Ejaculatory function and quality of life are assessed using the Male Sexual Health Questionnaire-Ejaculatory Dysfunction (MSHQ-EjD) and the International Index of Erectile Function-15 (IIEF-15) at both timepoints. Each questionnaire takes no longer than 5 minutes, and both should be able to be completed within 10 minutes. The duration of observation is three months post-operatively.
Sponsors
Blacktown Hospital, Western Sydney Local Health District
Eligibility
Sex/Gender
Male
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Adult males aged 18 years or older scheduled to undergo TURP for benign prostatic hyperplasia. Sexually active, defined as having ejaculated at least once in the preceding three months. Willing and able to provide informed consent. Able to collect and transport PEU samples and complete English-language study questionnaires. Available for three month post-operative follow-up. Baseline PEU confirming antegrade ejaculation with sperm count of greater than or equal to 5/HPF.
Exclusion criteria
Azoospermia or severe oligospermia (less than 5 sperm/HPF) on baseline PEU. Prior prostate surgery, concurrent prostate cancer diagnosis, previous bladder neck incision or urethral surgery. Pre-existing complete ejaculatory dysfunction or neurological conditions affecting ejaculation. History of retroperitoneal surgery or lymph node dissection. Severe erectile dysfunction (IIEF less than 8). Active urinary tract infection. Unable to comply with follow-up or provide PEU samples. Unable to complete questionnaires in English. Alpha-blocker use is permitted on the proviso the participant has no pre-existing subjective ejaculatory dysfunction.
Outcome results
None listed