Preservation of Ejaculation in Men Undergoing Surgery for Enlarged Prostate in NYC:  Bipolar TURP, Greenlight Laser, Holmium Laser, and Laser Prostate Enucleation.

by Alex Shteynshlyuger MD

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Ejaculation Preserving Treatment for Men with Enlarged Prostate and Urinary Retention in NYC

Can Ejaculation Problems be Avoided in Surgical Treatment of Enlarged Prostate?

Traditional prostate surgeries such as TURP, bipolar TURP, and laser enucleation of prostate result in a high incidence of ejaculation problems. Lack of ejaculation also known as retrograde ejaculation or unejaculation is one of the most common side effects of prostate surgeries.

While unejaculation or lack of ejaculation is not dangerous, it can be bothersome to patients and their sexual partners who are conditioned to expect ejaculation after intercourse and masturbation.

Orgasm and Ejaculation: Important Distinctions

While orgasm and ejaculation are separate events, because they occur simultaneously, many men associate orgasm with ejaculation.  Many men who need to have treatment for enlarged prostate or urinary retention worry that they will not have an orgasm if they do not have ejaculation after undergoing a procedure such as bipolar TURP and Greenlight laser ablation of the prostate.

It is important to realize that ejaculation and orgasm at 2 separate events.  Patients who have a normal orgasm before prostate surgery can expect to have normal orgasm after treatment for enlarged prostate with procedures such as TURP, bipolar TURP, and ablation or enucleation procedures with Greenlight laser or Holmium laser (HoLEP / HoLAP).  Orgasm will be preserved even if there is no ejaculation.

Men  Who Cannot Ejaculate or Orgasm Before Prostate Surgery

There are some men who are unable to have an orgasm for one reason or another. Most commonly this occurs in people with diabetes or other neurological conditions that affect the nerves that control orgasmic function.  Having prostate surgery will not have a noticeable change since these men lack orgasm to start with.  Similarly, men who are unable to ejaculate, which is common in men with an enlarged prostate will not see a noticeable change after surgery since they did not have ejaculation prior to surgery.  There are no established effective treatments to recover ejaculation or orgasm in men who are unable to either orgasm or to ejaculate.  While the Urolift procedure is associated with some improvement in ejaculatory function, it may be of limited benefit to patients with very large prostates and patients with neurological problems such as diabetes.

Surgical Technique to Preserve Ejaculation in Men Undergoing Prostate Surgery.

Modern treatment for an enlarged prostate has evolved.  Procedures such as Urolift stent and Rezum procedure for BPH do not affect ejaculation function and as a matter of fact, the ejaculatory function is improved in many men who undergo these procedures.  Urolift and Rezum are good options for men with small and medium-sized prostate and moderate urinary symptoms.

For men with severe symptoms of an enlarged prostate, high postvoid residual and urine retention, Urolift and Rezum for BPH procedure are not likely to be sufficiently beneficial.  For these men, new surgical techniques have been developed in an effort to minimize the chances of unejaculation after surgical procedures for enlarged prostate such as bipolar TURP (epTURP), laser enucleation of the prostate, Greenlight laser and Holmium laser.

Ejaculation Preserving Prostate Surgery in New York City

At New York Urology Specialists, we perform prostate surgery with ejaculation preserving intent if so desired by the patient.  It is important to understand that there is no guarantee that ejaculation preserving surgery will succeed in its intent to preserve ejaculation.  However, studies show that 70-80% of men preserve ejaculation function after ejaculation-preserving TURP surgery.  Similar results are achievable with ejaculation preserving laser enucleation of prostate and laser ablation of the prostate.

Technical Considerations

Performing prostate procedures with ejaculation preserving intent involve preserving about 1 cm of tissue at the apex of the prostate.  The desired benefit of this modification to standard TURP procedure is the preservation of ejaculatory function.  The downside of ejaculation-preserving modification to prostate surgery is that prostate tissue is incompletely removed which may result in suboptimal surgical benefit when it comes to improvements in the urine stream, postvoid residual volume, and improvement in urinary symptoms.  Usually, the difference in urinary function is not significantly between standard and ejaculation-preserving technique. With both approaches, expected improvement in urinary function is very significant compared to what men experienced before surgery.

Why Choose New York Urology Specialists for Treatment of Urinary Retention Caused by Enlarged Prostate?

  • All treatment is performed by a Board-certified urologist experienced in treating men with symptoms of BPH using medical therapy, minimally invasive therapies, lasers, and open surgery.
  • We are one of the few practices in the region to offer a full range of options for treatment of BPH.
  • We offer BPH treatment options under local anesthesia which avoids the risks, costs and recovery from general anesthesia. Most men are able to return to office work and other normal activities the next day.
  • Extensive Experience: Hundreds of men treated successfully using medical therapy, Urolift, lasers for BPH (Holmium, Thulium, Evolve , Greenlight lasers), Bipolar TURP, traditional TURP, open suprapubic prostatectomy, robotic suprapubic prostatectomy for BPH.
  • We treat men with BPH who have heart problems (hypertension, CAD, CHF), renal failure (ESRD) on hemodialysis, men on blood thinners such as aspirin, Lovenox, Coumadin (Warfarin), apixaban, rivaroxaban (Xarelto).

Excellence-Urology_Care VasectomyWhen it comes to experience and innovation – New York Urology Specialists are a step ahead.  Better Science Means Better Care.  We specialize in minimally invasive highly effective treatment for symptoms of enlarged prostate and BPH. Many treatment procedures are performed in the convenience and privacy of office settings under local anesthesia.

If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: 646-663-4044


Medicare and major insurances accepted. Urologist.We offer affordable rates and financing options.

Schedule an Appointment with Dr. Shteynshlyuger:

Call today: 646-663-4044 or make an appointment online

Dr. Alex Shteynshlyuger is a fellowship trained board certified urologist with expertise in evaluation and treatment of urinary problems in men.  He uses modern effective and proven treatment methods including prostate enucleation and Urolift for BPH.  He is highly recommended by top primary care physicians in New York area.

He has successfully performed hundreds of prostate procedures in adults. Urolift procedures are performed in the office under local anesthesia, in surgical center and affiliated hospitals under anesthesia.

If you or someone you know has been experiencing urological symptoms, make an appointment to take advantage of Dr. Shteynshlyuger’s expert advice. Please feel free to Contact Us with any questions.


If you have any questions, to schedule a consultation or if you need a second opinion, please contact us or call: (646) 663-4044

We offer affordable, highest-quality urology care with or without insurance.   Find out our office hours or directions to our office. We offer weekday, weekend, and evening office hours.