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Ejaculatory dysfunctions (ED) are an important cause of postoperative dissatisfaction, which lead to a decrease in the intensity of orgasms in 50% of patients. ED is a cause for concern for almost a third of patients who need surgery. Surgical techniques have been developed to limit the occurrence of postoperative ED, but their results remain heterogeneous.
There are very few studies on the biomechanical anatomy of ejaculation. Ejaculation is a complex phenomenon involving different structures and in particular the Veru Montanum. This is the key element in the emission of ejaculate within the prostatic urethra. In addition, there is a structure located in the resection zone of the prostate adenoma. It has therefore been suggested that its resection was a primary source of ED.
A single observational study carried out in by Gil Vernet et al in 1994 evaluated on a single healthy 18-year-old volunteer the ejaculatory mechanism of expulsion using an endorectal probe recording the movements of the prostate, the bladder neck and of the proximal urethra during ejaculation.
A contemporary study of the biomechanics of the ejaculatory expulsion phase could confirm and improve understanding of the involvement of anatomical structures. The results of our study aim to adapt surgical techniques aimed at limiting the risk of postoperative ED.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Study intervention | Experimental | Transrectal ultrasound and Urethroscopy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Transrectal ultrasound | Other | Examinations for observation of the pre, per and post-ejaculatory phases |
|
| Measure | Description | Time Frame |
|---|---|---|
| Peri-urethral muscle contraction | Qualitative description of peri-urethral muscle contraction according to ultrasound videos analysis | At Day 0 |
| Urethra, bladder neck and prostate movements | Qualitative description of movements of the urethra, bladder neck and prostate according to ultrasound videos analysis | At Day 0 |
| Sperm flow within the prostatic urethra | Qualitative description of sperm flow within the prostatic urethra according to ultrasound videos analysis | At Day 0 |
| Spermatic fluid via the ejaculatory ducts | Qualitative description of the expulsion and flow of spermatic fluid via the ejaculatory ducts according to urethroscopy videos analysis | At Day 6 |
| Veru montanum mobility and urethral contraction. | Qualitative description of veru montanum mobility and urethral contraction according to urethroscopy videos analysis | At Day 6 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Benjamin Pradère, MD | Clinique La Croix du Sud | Study Director |
| Eric Bruguière, MD | Clinique Pasteur | Study Director |
| Vincent Misraï, MD | Clinique Pasteur | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Clinique Pasteur | Toulouse | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 40858456 | Result | Pradere B, Uleri A, Bruguiere E, Misrai V. Exploration of the Ejaculatory Anatomy Concept: The EJAC Study. Eur Urol. 2025 Aug 25:S0302-2838(25)00451-8. doi: 10.1016/j.eururo.2025.08.001. Online ahead of print. |
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| ID | Term |
|---|---|
| D000097910 | Ejaculatory Dysfunction |
| ID | Term |
|---|---|
| D005832 | Genital Diseases, Male |
| D000091662 | Genital Diseases |
| D000091642 | Urogenital Diseases |
| D012735 | Sexual Dysfunction, Physiological |
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| ID | Term |
|---|---|
| D036761 | Ultrasound, High-Intensity Focused, Transrectal |
| ID | Term |
|---|---|
| D057086 | High-Intensity Focused Ultrasound Ablation |
| D014464 | Ultrasonic Therapy |
| D003972 | Diathermy |
| D006979 | Hyperthermia, Induced |
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| Urethroscopy | Other | Examinations for observation of the pre, per and post-ejaculatory phases |
|
| D052801 | Male Urogenital Diseases |
| D013812 | Therapeutics |
| D055011 | Ablation Techniques |
| D013514 | Surgical Procedures, Operative |
| D011468 | Prostatectomy |
| D013521 | Urologic Surgical Procedures, Male |
| D013520 | Urologic Surgical Procedures |
| D013519 | Urogenital Surgical Procedures |