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Question
Dear Dr Lesie,

Last year I was diagnosed with BPH and underwent a TURP operation.  I now have retrograde ejaculation.

As I understand it, this is due to damage or removal of the sphincter, at the bladder neck.  The sphincter closes when a men ejaculates and prevents semen going into the bladder.

Is it necessary for the sphincter to be removed during a TURP operation?  Why can't the urologist just remove tissue inside the prostate and leave the bladder neck intact?

Is this normal practice or does it depend on the individual urologist.

Thank you for your time.

Regards,
Paul

Answer
Paul:

It is necessary to remove the internal sphincter when doing a TURP procedure as the prostate is intimately involved with it.  There is no way to leave the internal sphincter and do a proper TURP procedure.  Retrograde ejaculation is an expected consequence and this should have been explained to you prior to your surgery.  At this point, there is no way to fix this.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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