ReviewCentral European journal of urology2026
The role of supramontanal preservation in ejaculation-sparing after transurethral resection of the prostate: A systematic review and meta-analysis.
Review in Central European journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction: Transurethral resection of the prostate (TURP) is widely recognized as the gold standard surgical treatment for benign prostatic enlargement (BPE). However, despite its effectiveness, TURP is associated with male sexual dysfunction, with up to 70% of patients developing retrograde ejaculation. Recent evidence suggests that preserving supramontanal tissue around the verumontanum may preserve sexual outcomes. This study aims to assess the efficacy of supramontanal-sparing TURP as an ejaculation sparing approach in sexually active males with BPE through a systematic review and meta-analysis. Material and methods: The present review was performed using a systematic search, registered in PROSPERO (CRD42024614954), and followed PRISMA guideline. Sexual function and voiding outcomes were measured, including symptom scores, maximum flow rate (Q Results: Six studies involving 540 patients, supramontanal-sparing TURP was compared to conventional TURP. The supramontanal-sparing TURP significantly reduced retrograde ejaculation (RR = 0.26, 95% CI: 0.14-0.46, p <0.01) and preserved semen volume better (MD = 1.04 ml, 95% CI: 0.36-1.73, p <0.01). Both techniques showed comparable outcomes in voiding function, including postoperative maximum flow rate, IPSS scores, and post-void residual volume (p = 0.49, p = 0.97, and p = 0.82, respectively). Conclusions: The supramontanal-sparing TURP technique demonstrated lower rates of retrograde ejaculation, while achieving similar voiding outcomes compared to standard TURP. These findings highlight the potential for preserving antegrade ejaculation after TURP when using the supramontanal-sparing technique.
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