{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:56:10Z","timestamp":1791201370786,"version":"4.2.0"},"reference-count":23,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T00:00:00Z","timestamp":1791158400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Preservation of anterograde ejaculation after transurethral incision for primary bladder neck obstruction (PBNO) has traditionally been assessed with unvalidated binary self-report. We prospectively evaluated ejaculatory and erectile function after the ZANCLE (\u201cZ\u201d Anatomical Needle Cut Leads Ejaculation) technique using two validated patient-reported outcome instruments, the Male Sexual Health Questionnaire\u2013Ejaculatory Dysfunction Short Form (MSHQ-EjD-SF) and the International Index of Erectile Function-5 (IIEF-5). Methods: Forty consecutive patients undergoing ZANCLE for PBNO at a single institution were prospectively enrolled between June 2024 and July 2025. MSHQ-EjD-SF (ejaculatory function domain, items for force\/volume\/frequency, independent bother item) and IIEF-5 were administered at baseline and at 1, 6, and 12 months postoperatively, together with the binary anterograde-ejaculation question used in the parent cohort. Voiding parameters (Qmax, IPSS, PVR) are not described here, as they have already been reported for this technique by our group in a previously published series. Results: Median age was 41 years (IQR 35\u201355). The MSHQ-EjD-SF function domain score was unchanged from baseline to 12 months (10.8 \u00b1 1.3 vs. 11.0 \u00b1 1.1, \u0394+0.2, p = 0.52), while the bother item improved significantly (1.1 \u00b1 0.9 vs. 0.5 \u00b1 0.6, \u0394\u22120.6, p = 0.011). IIEF-5 total score remained stable throughout follow-up (20.1 \u00b1 3.0 vs. 20.5 \u00b1 2.8 at 12 months, \u0394+0.4, p = 0.58). Anterograde ejaculation was preserved by binary self-report in 100% of evaluable patients at every postoperative timepoint. Conclusions: Validated instruments confirm, with greater granularity than binary self-report, that the ZANCLE technique preserves ejaculatory function domain scores and erectile function while reducing ejaculation-related bother. These preliminary findings support incorporation of MSHQ-EjD-SF and IIEF-5 into future prospective evaluations of ejaculation-sparing bladder neck surgery.<\/jats:p>","DOI":"10.3390\/jcm15197699","type":"journal-article","created":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T10:57:46Z","timestamp":1791197866000},"page":"7699","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validated Assessment of Ejaculatory and Erectile Function After Unilateral \u201cZ\u201d-Shaped Bladder Neck Incision (ZANCLE): A Prospective Study Using the MSHQ-EjD Short Form and IIEF-5"],"prefix":"10.3390","volume":"15","author":[{"given":"Alessandro","family":"Calarco","sequence":"first","affiliation":[{"name":"Department of Urology, San Carlo di Nancy Hospital, GVM Care and Research, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Morgia","sequence":"additional","affiliation":[{"name":"Department of Urology, San Carlo di Nancy Hospital, GVM Care and Research, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo Maria","family":"Scornajenghi","sequence":"additional","affiliation":[{"name":"Department of Urology, San Carlo di Nancy Hospital, GVM Care and Research, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianna","family":"Paolillo","sequence":"additional","affiliation":[{"name":"Department of Urology, San Carlo di Nancy Hospital, GVM Care and Research, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Viscuso","sequence":"additional","affiliation":[{"name":"Department of Urology, San Carlo di Nancy Hospital, GVM Care and Research, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatrice","family":"Filippi","sequence":"additional","affiliation":[{"name":"Department of Urology, San Carlo di Nancy Hospital, GVM Care and Research, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Tufano","sequence":"additional","affiliation":[{"name":"Department of Urology, San Carlo di Nancy Hospital, GVM Care and Research, 00165 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1016\/S0022-5347(05)64846-X","article-title":"Lower urinary tract symptoms in young men: Videourodynamic findings and correlation with noninvasive measures","volume":"168","author":"Nitti","year":"2002","journal-title":"J. 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