A 70-year-old man with benign prostatic hyperplasia (IPSS 24, prostate volume 85 mL, Q-max 6 mL/s) is on tamsulosin but remains symptomatic. Surgical options are discussed. The procedure with the lowest risk of retrograde ejaculation compared to standard TURP is:

• A Open (Millin's retropubic) prostatectomy
• B Holmium laser enucleation of the prostate (HoLEP)
• C Prostatic urethral lift (UroLift) ✓
• D Bipolar TURP

Explanation

Prostatic urethral lift (UroLift) mechanically retracts lateral lobes without tissue ablation and has the unique advantage of preserving ejaculatory function in nearly all patients — the rate of retrograde ejaculation is <1%. TURP, HoLEP, and open prostatectomy all carry substantial rates (60–90%) of retrograde ejaculation due to disruption of the bladder neck.

Reference: Bailey & Love's Short Practice of Surgery, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.