The basic principle of the technique is retrograde enucleation of the prostate and fragmentation of the enucleated tissue so that it can be removed through the operating channel of the resectoscope; therefore, the seminal vesicles are intact. The distance between the ejaculatory ducts of the verumontanum and the proximal edge of the external sphincter muscle are noted to judge the limits of resection. The verumontanum remains the distal margin of resection in most circumstances.
Post-operative dysuria is the most common complication. Retrograde ejaculation occurs in 75-80% of patients but no post-operative impotence has been reported. In retrograde ejaculation, the tiny muscle that shuts the bladder does not function normally. This allows all or part of the semen to travel backward (retrograde) into the bladder at the time of ejaculation. When this happens, less semen comes out the tip of the penis. Laser prostatectomy is advised for patients wanting to maintain ejaculation.
Edited by morekare on April 12 2006 at 6:28am
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