(293) Limitations in Reporting and Assessment Tools for Retrograde Ejaculation after Surgical BPH treatment: A Scoping Review

Abstract

Introduction Antegrade ejaculation is a fundamental aspect of sexual satisfaction for many individuals, but retrograde ejaculation (RE) occurs in up to 75 % of some surgical treatments of benign prostatic hyperplasia. Unfortunately, clinicians commonly focus only primarily on erection strength, and existing tools inadequately characterize rates and bother associated with RE after BPH treatment. Objective This review provides critical appraisal of existing tools used to assess RE and emphasizes the importance of preoperative counseling of this complication prior to surgical BPH treatment. Methods A literature review was conducted in June of 2022 using Embase, Medline, and Web of Science to identify relevant manuscripts on “men sexual health”, “men’s sexual health questionnaire (MSHQ), and “retrograde”, “dry”, or “backward” “ejaculate” or “orgasm” from 1946 to June 2022. Eligibility criteria were established by using Population, Intervention, Control, and Outcome (PICO) tool for men with BPH symptoms treated with surgical intervention and developed postoperative RE. Criteria for exclusion were manuscripts in non-English language and studies reporting rates of RE without specifying the criteria used to diagnose the condition. Results A literature review was conducted in June of 2022 using Embase, Medline, and Web of Science to identify relevant manuscripts on “men sexual health”, “men’s sexual health questionnaire (MSHQ), and “retrograde”, “dry”, or “backward” “ejaculate” or “orgasm” from 1946 to June 2022. Eligibility criteria were established by using Population, Intervention, Control, and Outcome (PICO) tool for men with BPH symptoms treated with surgical intervention and developed postoperative RE. Criteria for exclusion were manuscripts in non-English language and studies reporting rates of RE without specifying the criteria used to diagnose the condition. Conclusions Significant limitations exist in the tools presently available for the reporting of RE related to BPH treatment. With ejaculation playing a very important role in sexual satisfaction for many men, more robust and specific instruments are needed to help with the diagnosis. Through development of such tools, patients will be better counseled and satisfaction with treatments will be improved. Optimized questioning needs to take into consideration both baseline and post-treatment ejaculatory function – including granular specifics on force, volume, sensation, and level of bother rather than general questions on ejaculatory functioning measured on a very broad scale. Disclosure No