Sexual Dysfunction After Transurethral Resection of the Prostate (TURP)

Initial Assessment and Management

• The American Urological Association suggests assessing for concurrent erectile dysfunction, as this may contribute to difficulty achieving orgasm and should be managed according to standard ED guidelines 1
• Review of medications that may impair orgasm, including antidepressants, antihypertensives, and other agents, is recommended 1

Treatment Approaches

• Alpha-adrenergic agonists (such as pseudoephedrine or imipramine) have been used off-label to restore antegrade ejaculation in some cases of retrograde ejaculation, though evidence is limited and this is not standard practice 1
• Referral to a mental health professional with expertise in sexual health should be considered for patients with true anorgasmia, as psychological factors are often contributory 1
• Psychosexual counseling and behavioral therapy may help address performance anxiety, relationship issues, or other psychological barriers to achieving orgasm 1
• Treatment of any concurrent erectile dysfunction according to standard guidelines is necessary, as adequate erectile rigidity is necessary for orgasm 1
• Review and potential adjustment of medications that may impair orgasm is recommended 1