{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:52:55Z","timestamp":1787028775681,"version":"build-2736575974"},"reference-count":25,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,20]],"date-time":"2023-03-20T00:00:00Z","timestamp":1679270400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Italian Ministry of University and Research","award":["MIUR-PRIN 2017S9KTNE_003"],"award-info":[{"award-number":["MIUR-PRIN 2017S9KTNE_003"]}]},{"name":"\u201cSapienza\u201d University of Rome Faculty of Medicine","award":["MIUR-PRIN 2017S9KTNE_003"],"award-info":[{"award-number":["MIUR-PRIN 2017S9KTNE_003"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Primary Bladder Neck Obstruction (PBNO) management provides medical and surgical treatment, such as transurethral incisions that can lead to retrograde ejaculation. The aim of this study was to investigate the maintenance of anterograde ejaculation and semen quality before and after this surgical procedure. A retrospective evaluation was carried out between 2011 and 2020. A total of 73 patients diagnosed with PBNO were recruited. Ejaculatory function, semen quality, and the fertility of recruited subjects were evaluated. Semen parameters\u2014Baseline, 8.2% of patients were oligozoospermic and 12.3% had a semen volume below the WHO 2010 fifth percentile. Post-surgery, 20% of patients were oligozoospermic. We detected a significant decrease in total sperm number, a significant increase in the number of abnormal forms, and a reduction in the leukocyte concentration. Ejaculatory function\u2014A total of 7.7% of patients reported anejaculation after transurethral incision of the bladder neck. Fertility\u20149.2% of the patients already had children before surgery; 13.8% had naturally conceived children in the years following surgery; 76.9% had no desire for paternity at the time. Our data have important implications for sperm bank management. The alterations in semen parameters and the risk of anejaculation suggest that the use of sperm cryopreservation before surgery for PBNO should be encouraged.<\/jats:p>","DOI":"10.3390\/life13030842","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T03:15:03Z","timestamp":1679368503000},"page":"842","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Bladder Neck Obstruction: Experience and Management in a Sperm Bank"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6055-6794","authenticated-orcid":false,"given":"Maria Neve","family":"Hirsch","sequence":"first","affiliation":[{"name":"Laboratory of Seminology\u2013Sperm Bank \u201cLoredana Gandini\u201d, Department of Experimental Medicine, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6042-6474","authenticated-orcid":false,"given":"Francesco","family":"Pallotti","sequence":"additional","affiliation":[{"name":"Laboratory of Seminology\u2013Sperm Bank \u201cLoredana Gandini\u201d, Department of Experimental Medicine, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5297-2448","authenticated-orcid":false,"given":"Fabiana","family":"Faja","sequence":"additional","affiliation":[{"name":"Laboratory of Seminology\u2013Sperm Bank \u201cLoredana Gandini\u201d, Department of Experimental Medicine, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Buonacquisto","sequence":"additional","affiliation":[{"name":"Laboratory of Seminology\u2013Sperm Bank \u201cLoredana Gandini\u201d, Department of Experimental Medicine, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4629-5222","authenticated-orcid":false,"given":"Gaia","family":"Cicolani","sequence":"additional","affiliation":[{"name":"Laboratory of Seminology\u2013Sperm Bank \u201cLoredana Gandini\u201d, Department of Experimental Medicine, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Chiara","family":"Conflitti","sequence":"additional","affiliation":[{"name":"Laboratory of Seminology\u2013Sperm Bank \u201cLoredana Gandini\u201d, Department of Experimental Medicine, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Di Chiano","sequence":"additional","affiliation":[{"name":"Laboratory of Seminology\u2013Sperm Bank \u201cLoredana Gandini\u201d, Department of Experimental Medicine, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Lenzi","sequence":"additional","affiliation":[{"name":"Laboratory of Seminology\u2013Sperm Bank \u201cLoredana Gandini\u201d, Department of Experimental Medicine, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Lombardo","sequence":"additional","affiliation":[{"name":"Laboratory of Seminology\u2013Sperm Bank \u201cLoredana Gandini\u201d, Department of Experimental Medicine, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9699-8703","authenticated-orcid":false,"given":"Donatella","family":"Paoli","sequence":"additional","affiliation":[{"name":"Laboratory of Seminology\u2013Sperm Bank \u201cLoredana Gandini\u201d, Department of Experimental Medicine, \u201cSapienza\u201d University of Rome, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,20]]},"reference":[{"key":"ref_1","first-page":"S12","article-title":"Primary bladder neck obstruction in men and women","volume":"7","author":"Nitti","year":"2005","journal-title":"Rev. Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"836","DOI":"10.1016\/S0090-4295(96)00038-6","article-title":"Etiology of voiding dysfunction in men less than 50 years of age","volume":"47","author":"Kaplan","year":"1996","journal-title":"Urology"},{"key":"ref_3","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. Urol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1007\/s00345-003-0343-2","article-title":"Unilateral transurethral incision for primary bladder neck obstruction: Symptom relief and fertility preservation","volume":"21","author":"Kochakarn","year":"2003","journal-title":"World J. Urol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"2063","DOI":"10.1016\/S0022-5347(17)32309-1","article-title":"Urodynamic evidence of vesical neck obstruction in men with misdiagnosed chronic nonbacterial prostatitis and the therapeutic role of endoscopic incision of the bladder neck","volume":"152","author":"Kaplan","year":"1994","journal-title":"J. Urol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1016\/S0022-5347(17)55851-6","article-title":"The evaluation of bladder neck dysfunction","volume":"123","author":"Webster","year":"1980","journal-title":"J. Urol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1016\/S0022-5347(01)65605-2","article-title":"Primary bladder neck obstruction: Urodynamic findings and treatment results in 36 men","volume":"156","author":"Trockman","year":"1996","journal-title":"J. Urol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1159\/000019514","article-title":"Late results after transurethral bladder neck incision","volume":"33","author":"Neykov","year":"1998","journal-title":"Eur. Urol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"972","DOI":"10.1016\/S0022-5347(17)45942-8","article-title":"Unsuspected proximal urethral obstruction in young and middle-aged men","volume":"135","author":"Norlen","year":"1986","journal-title":"J. Urol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1007\/BF02552137","article-title":"Transurethral incision of the bladder neck: An objective and subjective evaluation of its efficacy","volume":"27","author":"Yousef","year":"1995","journal-title":"Int. Urol. Nephrol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1111\/j.1464-410X.1985.tb06413.x","article-title":"Ejaculation and sexual function after endoscopic bladder neck incision","volume":"57","author":"Hedlund","year":"1985","journal-title":"Br. J. Urol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"17","DOI":"10.3109\/00365598009181184","article-title":"Functional bladder neck obstruction. Late results after endoscopic bladder neck incision","volume":"14","author":"Andersen","year":"1980","journal-title":"Scand. J. Urol. Nephrol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1111\/j.1464-410X.1983.tb06562.x","article-title":"Extended bladder neck incision for outflow obstruction in male patients","volume":"55","author":"Delaere","year":"1983","journal-title":"Br. J. Urol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1111\/j.1464-410X.1985.tb08986.x","article-title":"Functional bladder neck obstruction. Results of endoscopic bladder neck incision in 131 consecutive patients","volume":"57","author":"Christensen","year":"1985","journal-title":"Br. J. Urol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1111\/j.1464-410X.1982.tb13531.x","article-title":"A subjective and urodynamic assessment of unilateral bladder neck incision for bladder neck obstruction","volume":"54","author":"Moisey","year":"1982","journal-title":"Br. J. Urol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/j.1464-410X.1988.tb04298.x","article-title":"Long-term follow-up of unilateral bladder neck incision","volume":"62","author":"Mobb","year":"1988","journal-title":"Br. J. Urol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1085","DOI":"10.1007\/s40618-022-01741-6","article-title":"Management of male factor infertility: Position statement from the Italian Society of Andrology and Sexual Medicine (SIAMS): Endorsing Organization: Italian Society of Embryology, Reproduction, and Research (SIERR)","volume":"45","author":"Ferlin","year":"2022","journal-title":"J. Endocrinol. Invest."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1016\/j.eururo.2021.08.014","article-title":"European Association of Urology Guidelines on Male Sexual and Reproductive Health: 2021 Update on Male Infertility","volume":"80","author":"Minhas","year":"2021","journal-title":"Eur Urol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1177\/03915603211025236","article-title":"Pre-test anxiety levels and postoperative pain in non-obstructive azoospermic patients: Is klinefelter syndrome a predisposing factor?","volume":"89","author":"Tangal","year":"2022","journal-title":"Urol. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1016\/j.urolonc.2017.11.002","article-title":"Fertility preservation for men with testicular cancer: Is sperm cryopreservation cost effective in the era of assisted reproductive technology?","volume":"36","author":"Gilbert","year":"2018","journal-title":"Urol. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1007\/s40618-022-01778-7","article-title":"The impact of male factors and their correct and early diagnosis in the infertile couple\u2019s pathway: 2021 perspectives","volume":"45","author":"Pallotti","year":"2022","journal-title":"J. Endocrinol. Invest."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1007\/978-3-030-21664-1_9","article-title":"Cryopreservation of Sperm: Effects on Chromatin and Strategies to Prevent Them","volume":"1166","author":"Paoli","year":"2019","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"506","DOI":"10.3389\/fendo.2018.00506","article-title":"Fatherhood and Sperm DNA Damage in Testicular Cancer Patients","volume":"9","author":"Paoli","year":"2018","journal-title":"Front. Endocrinol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1159\/000111725","article-title":"Modified transurethral incision of the bladder neck treating primary bladder neck obstruction in young men: A method to improve voiding function and to preserve antegrade ejaculation","volume":"80","author":"Yang","year":"2008","journal-title":"Urol. Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/S0094-0143(21)00063-X","article-title":"A urodynamic review of bladder outlet obstruction in the male and its clinical implications","volume":"6","author":"Warwick","year":"1979","journal-title":"Urol. Clin. N. Am."}],"container-title":["Life"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/3\/842\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:59:45Z","timestamp":1760122785000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-1729\/13\/3\/842"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,20]]},"references-count":25,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3]]}},"alternative-id":["life13030842"],"URL":"https:\/\/doi.org\/10.3390\/life13030842","relation":{},"ISSN":["2075-1729"],"issn-type":[{"value":"2075-1729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,20]]}}}