urovestВестник урологииUrology Herald2308-6424Rostov State Medical University10.21886/2308-6424-2025-13-4-79-88urovest-1114Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWS ARTICLEЭякуляторно-протективные методики в хирургическом лечении гиперплазии предстательной железыEjaculatory-projective techniques in the surgical treatment of benign prostatic hyperplasiahttps://orcid.org/0000-0001-8060-6691КорчагинМ. П.KorchaginM. P.

Михаил Павлович Корчагин

Москва

Mikhail P. Korchagin

Moscow

mihailsun@mail.ruhttps://orcid.org/0000-0002-9769-5907АндреевР. Ю.AndreevR. Yu.

Роман Юрьевич Андреев – канд. мед. наук

Москва

Roman Yu. Andreev – Cand.Sc.(Med).

Moscow

romandree@gmail.comhttps://orcid.org/0000-0003-4511-5998КолонтаревК. Б.KolontarevK. B.

Константин Борисович Колонтарев – д-р мед. наук

Москва

Konstantin B. Kolontarev – Dr.Sc.(Med).

Moscow

kb80@yandex.ruhttps://orcid.org/0000-0002-6096-5723ПушкарьД. Ю.PushkarD. Yu.

Дмитрий Юрьевич Пушкарь – д-р мед. наук, профессор; акад. РАН

Москва

Dmitry Yu. Pushkar – Dr.Sc.(Med), Full Prof., Acad. of the RAS

Moscow

pushkardm@mail.ruРоссийский университет медициныРоссияRussian University of MedicineRussian FederationМосковский многопрофильный научно-клинический центр им. С.П. БоткинаРоссияBotkin City Clinical HospitalRussian FederationРоссийский университет медицины; Московский многопрофильный научно-клинический центр им. С.П. БоткинаРоссияRussian University of Medicine; Botkin City Clinical HospitalRussian Federation2025151120251347988Copyright © Корчагин М.П., Андреев Р.Ю., Колонтарев К.Б., Пушкарь Д.Ю., 20252025Корчагин М.П., Андреев Р.Ю., Колонтарев К.Б., Пушкарь Д.Ю.Korchagin M.P., Andreev R.Y., Kolontarev K.B., Pushkar D.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.urovest.ru/jour/article/view/1114Введение

Введение. Ретроградная эякуляция имеет множество хорошо описанных причин, от фармакологических нарушений до вмешательства в механизмы иннервации при оперативном лечении гиперплазии предстательной железы (ГПЖ).

Цель исследования

Цель исследования. Изучить вопрос анатомо-физиологических особенностей ретроградной эякуляции и проанализировать накопленный научный материал, посвящённый частоте сохранения антеградной эякуляции после различных эякуляторно-протективных техник на основании современной медицинской литературы.

Материалы и методы

Материалы и методы. Проведён обзор литературы с использованием баз данных PubMed, Medline и Scopus за период с 1966 по 2024 год. Для дифференциального поиска использованы ключевые слова «гиперплазия предстательной железы», «ретроградная эякуляция», «эякуляторно-протективные техники», «трансуретральная энуклеация», «оценка эякуляторных расстройств», «физиология эякуляции». Проработаны 1123 источника литературы, в обзор включена 51 работа.

Результаты

Результаты. Определены основные взгляды на анатомо-физиологическую составляющую ретроградной эякуляции и методы субъективной оценки эякуляторных расстройств, а также освещены современные эякуляторно-протективные техники и альтернативные методы хирургического лечения ГПЖ. Высокотехнологичная медицинская помощь в лечении ГПЖ уже сегодня дарит шанс пациентам после трансуретральных операций иметь детей, благодаря чему запрос пациента сегодня – исчезновение симптомов заболевания, а также повышение удовлетворённости жизнью в психоэмоциональном и социальном аспектах.

Заключение

Заключение. Разработка и применение эякуляторно-протективных методик значительно повышает социальную и психоэмоциональную оценку пациентов, перенёсших оперативное лечение по поводу ГПЖ. В связи с этим требуется дальнейшее изучение проблемы ретроградной эякуляции, проведение научно-практических исследований, а также разработка новых методик хирургического лечения ГПЖ для нивелирования данного послеоперационного осложнения.

Introduction

Introduction. Retrograde ejaculation (RE) has many well-described causes, ranging from pharmacological disturbances to interference with innervation mechanisms during surgical treatment of benign prostatic hyperplasia (BPH).

Objective

Objective. To explore the anatomical and physiological aspects of retrograde ejaculation (RE) and to critically evaluate published evidence regarding the preservation of antegrade ejaculation following various ejaculatory-sparing procedures, drawing on the latest medical literature.

Materials & Methods

Materials & Methods. A comprehensive literature search was performed across PubMed, MEDLINE, and Scopus databases for the period 1966–2024. Differential searches employed the keywords «benign prostatic hyperplasia», «retrograde ejaculation», «ejaculatory-protective techniques», «transurethral enucleation», «assessment of ejaculatory disorders», and «physiology of ejaculation». In total, 1126 sources were screened, with 51 articles included for review.

Results

Results. The main perspectives on the anatomo-physiological basis of RE were identified, alongside the subjective methods used to assess ejaculatory disorders. Additionally, current ejaculatory-protective techniques and alternative surgical approaches for the treatment of BPH were highlighted. Advances in high-tech medical care for BPH have already provided patients undergoing transurethral procedures with the possibility of fathering children. Consequently, patient expectations today extend beyond mere symptom relief to include improved psycho-emotional wellbeing and enhanced quality of life in social aspects.

Conclusion

Conclusion. Implementation of ejaculatory-sparing surgical techniques markedly improves the psychosocial outcomes and overall quality of life for patients treated for BPH. Continued investigation into the mechanisms of RE, as well as the refinement of surgical methods, is warranted to further mitigate this complication and optimize patient-centred care.

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The authors declare that there are no conflicts of interest present.