Exploration of Ejaculation Changing Mechanism After Surgery for Benign Prostatic Hyperplasia

Study Overview
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Brief Summary
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Every year in France, more than 60 000 people are operated for benign prostatic hyperplasia (BPH). This surgery is accompanied by a change or even a loss of ejaculations externalized what constitutes the main constraint for patients. Empirically, the investigators talk to the patient retrograde ejaculation to explain a possible loss of ejaculation. Yet the underlying mechanism of this modification or loss of ejaculation remains completely unknown. Yet the underlying mechanism of this modification or loss of ejaculation remains completely unknown. No study could not determine whether the predominant mechanism was a real retrograde ejaculation or aspermia. Moreover, technical changes are sometimes tempted to preserve antegrade ejaculation but no scientific rationale can not validate.

Detailed Description
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Every year in France, more than 60 000 people are operated for benign prostatic hyperplasia (BPH). This surgery is accompanied by a change or even a loss of ejaculations externalized what constitutes the main constraint for patients. Empirically, the investigators talk to the patient retrograde ejaculation to explain a possible loss of ejaculation. Yet the underlying mechanism of this modification or loss of ejaculation remains completely unknown. No study could not determine whether the predominant mechanism was a real retrograde ejaculation or aspermia. Moreover, technical changes are sometimes tempted to preserve antegrade ejaculation but no scientific rationale can not validate.

Official Title
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Exploration of Ejaculation Changing Mechanism After Surgery for Benign Prostatic Hyperplasia

Conditions
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Prostate, Ejaculation, Benign Prostatic Hyperplasia

Intervention / Treatment
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* Procedure: Search retrograde ejaculation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Man, at least 18 years, which is scheduled for a BPH surgery Sexually active Measurement of Residual postvoid less than 6 months Patients accepting the constraints of the study Signed Consent Affiliate or beneficiary of social security system. Exclusion Criteria: Patients unable to understand the study or to give consent Patients with known infertility Patients previously operated prostate Patients previously treated with a natural prostate treatment (radiotherapy, microwave, radio frequency, ultrasound) Patients with known urethral stenosis before surgery Patient with impaired preoperative in ejaculation Patient under guardianship or under judicial protection Patient subject to psychiatric care

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Search retrograde ejaculation<br>Sperm count (spz) after orgasm achieved by masturbation will be measured, corresponding to the sum of spz collected in the ejaculate (E) and the first urine after orgasm (U). These measures will be made before surgery (E1 and U1) and after surgery (E2 and U2). The values E1, E2, U1 and U2 will be achieved by multiplying the concentration of spz per unit volume by the total volume of collection. | Procedure: Search retrograde ejaculation<br>* Sperm count (spz) after orgasm achieved by masturbation will be measured, corresponding to the sum of spz collected in the ejaculate (E) and the first urine after orgasm (U). These measures will be made before surgery (E1 and U1) and after surgery (E2 and U2). The values E1, E2, U1 and U2 will be achieved by multiplying the concentration of spz per unit volume by the total volume of collection.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Sperm count | Sperm count (spz) after orgasm achieved by masturbation will be measured, corresponding to the sum of spz collected in the ejaculate (E) and the first urine after orgasm (U). These measures will be made before surgery (E1 and U1) and after surgery (E2 and U2). The values E1, E2, U1 and U2 will be achieved by multiplying the concentration of spz per unit volume by the total volume of collection. | Baseline and 9 months | 
| aspermia (A) | Aspermia is determined by the ratio of the difference of total spz between before surgery and after surgery on the number of spz before surgery | Baseline and 9 months | 
| retrograde ejaculation (R) | retrograde ejaculation is determined by the difference in percentage of retrograde ejaculation between postoperative and preoperative | Baseline and 9 months | 
| Evaluation of the coefficient C | A and R will be subtracted to obtain the coefficient C | 9 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Type of surgery | determination of factors influencing the ejaculation changing mechanism after BPH surgery by evaluation of the coefficient C depending of type of surgery | 9 months | 
| Preoperative prostate volume | determination of factors influencing the ejaculation changing mechanism after BPH surgery by preoperative prostate volume measurement by ultrasound | 9 months | 
| Evaluation of the coefficient C depending on changing sexual symptoms relating to the change of sexuality questionary (IIEF15) before and after surgery | determination of factors influencing the ejaculation changing mechanism after BPH surgery by changing sexual symptoms relating to the change of sexuality questionary (IIEF15) before and after surgery | Baseline and 9 months | 
| Changing in urinary output before and after surgery | determination of factors influencing the ejaculation changing mechanism after BPH surgery by changing in urinary output before and after surgery | Baseline and 9 months | 
| Evaluation of urinary symptoms questionary (IPSS) before and after surgery | determination of factors influencing the ejaculation changing mechanism after BPH surgery by changing in urinary symptoms corresponding to the change in score in the evaluation of urinary symptoms questionary (IPSS) before and after surgery | Baseline and 9 months | 
| Degree of resection evaluated by pre/postoperative prostate volume ratio, ratio of prostatic specific antigen (PSA) preoperative / postoperative and measurement of the resected weight (or the number of joules used in case of laser vaporization). | determination of factors influencing the ejaculation changing mechanism after BPH surgery by assessment of degree of resection | Baseline and 9 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Ejaculation, Benign Prostatic Hyperplasia, Prostate