Sexual Function and Fertility in Patients Treated for Posterior Urethral Valves

Pyospermia in an adult cohort with persistent lower urinary tract symptoms and a history of ablated posterior urethral valve

“…This might also modify semen pH. In the study by Woodhouse et al very alkaline semen was a notable finding [1]. In the present study semen pH averaged 7.45, a more typical value.…”

“…Impaired function of the posterior urethra and the ejaculatory mechanism has been postulated; either due directly to the valve or injury caused during valve resection. Woodhouse et al have described slow and dry ejaculation in half of the patients studied [1]. The possibility of damage also exists for abnormal exposures from a poorly emptying bladder and incompetent bladder neck allowing urine into the ejaculatory duct system.…”

“…There are few data from long-term follow up of sexual function and fertility in patients with a history of PUV. We previously demonstrated the ability of such patients to achieve erection adequate for coitus along with the capability to produce and expel ejaculate; however we also found seminal abnormalities, including viscous, alkaline semen [1]. There is also little known about the long-term urinary tract characteristics and symptoms of patients with ablated PUV.…”

Congenital genitourinary anomalies and sexual function

“…23 In review of 21 men who were treated for posterior urethral valves in infancy, erections and orgasms were adequate in 20; however, nine had either slow or dry ejaculation, and only three fathered children. 24 Although the reasons for these issues are unknown, it is clear that posterior urethral valves affect fertility in several ways.…”

Posterior urethral valves: Pre- and postnatal management

“…Retrograde ejaculation or ineffective forward propulsion of semen may occur secondary to a dilated posterior urethra and open bladder neck. In the largest series available, Woodhouse et al [58] noted that of 21 patients with a history of urethral valves, only one half had normal ejaculation. Renal insufficiency appears to be the primary insult to potency and libido.…”