Bladder Neck Resection with Preservation of Antegrade Ejaculation: Basir Technique

PURPOSE: To evaluate a new method of bladder neck resection and to determine if antegrade ejaculation is preserved thereafter. PATIENTS AND METHODS: Two groups of patients were treated for their bladder neck obstruction. Group A, composed of 20 patients, was treated by bladder neck resection with preservation of more than 1 cm proximal to the verumontanum. Group B, also consisting of 20 patients, was treated by the old technique. Patients were evaluated before and after resection by semen volume, sperm count, symptoms, and urodynamic testing. RESULTS: In group A, antegrade ejaculation was maintained in 17 of the 20 patients (85%), while in 2 patients, only a small amount of semen was ejaculated and in 1 patient, complete retrograde ejaculation was reported. In group B, only 4 patients (20%) preserved antegrade ejaculation, and retrograde ejaculation occurred in 16 patients (80%). CONCLUSION: With preservation of >1 cm of the supramontanal part of the urethra during bladder neck resection, we could avoid the complication of retrograde ejaculation in those young patients who wish to preserve fertility.