Ejaculatory Behavior and Seminal Vesicle Size During Radical Prostatectomy

NCT ID: NCT07243795

Last Updated: 2025-12-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

NOT_YET_RECRUITING

Clinical Phase

NA

Total Enrollment

40 participants

Study Classification

INTERVENTIONAL

Study Start Date

2025-12-01

Study Completion Date

2026-10-09

Brief Summary

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The goal of this clinical trial is to learn if recent ejaculation or abstinence before surgery affects seminal vesicle size and dissection-related surgical factors in adult men with prostate cancer undergoing radical prostatectomy. The main questions it aims to answer are:

Does ejaculation within 36 hours before surgery reduce seminal vesicle size compared to abstinence of 72 hours or more?

Does seminal vesicle size affect the ease or difficulty of surgical dissection during radical prostatectomy?

Researchers will compare an ejaculation group to an abstinence group to see if seminal vesicle volume and intraoperative surgical parameters differ between them.

Participants will:

Follow specific instructions to either ejaculate or abstain before surgery

Undergo a transrectal ultrasound (TRUS) to measure seminal vesicle size after anesthesia but before surgery

Have their surgical dissection time and difficulty rated by the operating surgeon

Detailed Description

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Radical prostatectomy (RP) remains a cornerstone treatment for localized prostate cancer. During RP, the anatomical dissection of seminal vesicles (SVs) can be challenging, and SV volume may influence intraoperative visibility, dissection ease, and the risk of complications.

Recent imaging studies suggest that ejaculatory activity significantly affects SV size. In particular, abstinence has been associated with larger SV volumes on MRI and TRUS, while ejaculation may lead to temporary SV shrinkage. These physiological changes, though well-documented radiologically, have not been systematically studied in a surgical setting.

This trial aims to explore whether ejaculatory behavior in the days before RP alters the surgical anatomy and impacts dissection-related metrics. Forty adult male patients with biopsy-confirmed prostate cancer, scheduled for RP, will be randomized in a 1:1 ratio into two groups:

Ejaculation group: At least one ejaculation within 36 hours preoperatively.

Abstinence group: No ejaculation for ≥72 hours before surgery.

Under anesthesia and prior to surgery, transrectal ultrasound (TRUS) will be performed to measure bilateral SV dimensions. The average volume will serve as the primary endpoint. Intraoperative outcomes include dissection time, visual clarity, and perceived difficulty rated by the primary surgeon using a Likert scale. SV volume from final pathology reports will also be collected and compared.

This is a low-risk, behavior-based interventional study involving no experimental drug or device. The main purpose is to assess whether preoperative sexual behavior can be optimized to improve surgical planning and efficiency. Alpha-blocker usage and other potential confounders will be documented and adjusted for in the analysis.

If significant anatomical or procedural differences are observed, findings from this study may inform future multicenter research and guide preoperative patient counseling for RP.

Conditions

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Prostate Cancer Patients Undergoing Radical Prostatectomy

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants will be randomly assigned in a 1:1 ratio to either a recent ejaculation group or an abstinence group before radical prostatectomy.
Primary Study Purpose

HEALTH_SERVICES_RESEARCH

Blinding Strategy

SINGLE

Outcome Assessors
The operating surgeon was masked to the participant's group assignment. Group allocation was concealed until after surgery. Neither the participant nor the research investigator performing TRUS was masked.

Study Groups

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Recent Ejaculation Group

Participants in this group will be instructed to have at least one ejaculation within 36 hours before surgery. Under anesthesia, they will undergo transrectal ultrasound (TRUS) to measure seminal vesicle volume prior to radical prostatectomy. Intraoperative dissection time, difficulty, and visual clarity will also be recorded.

Group Type EXPERIMENTAL

Recent Ejaculation

Intervention Type BEHAVIORAL

Participants are instructed to ejaculate at least once within 36 hours prior to radical prostatectomy. This behavioral intervention is used to evaluate its effect on seminal vesicle volume and intraoperative dissection parameters.

Abstinence Group

Participants in this group will be instructed to abstain from ejaculation for at least 72 hours before surgery. Under anesthesia, they will undergo transrectal ultrasound (TRUS) to measure seminal vesicle volume prior to radical prostatectomy. Intraoperative dissection time, difficulty, and visual clarity will also be recorded.

Group Type ACTIVE_COMPARATOR

Preoperative Abstinence

Intervention Type BEHAVIORAL

Participants are instructed to abstain from ejaculation for at least 72 hours prior to radical prostatectomy. This behavioral intervention is used to assess whether prolonged seminal vesicle filling affects intraoperative anatomy and dissection.

Interventions

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Recent Ejaculation

Participants are instructed to ejaculate at least once within 36 hours prior to radical prostatectomy. This behavioral intervention is used to evaluate its effect on seminal vesicle volume and intraoperative dissection parameters.

Intervention Type BEHAVIORAL

Preoperative Abstinence

Participants are instructed to abstain from ejaculation for at least 72 hours prior to radical prostatectomy. This behavioral intervention is used to assess whether prolonged seminal vesicle filling affects intraoperative anatomy and dissection.

Intervention Type BEHAVIORAL

Other Intervention Names

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Ejaculation within 36 hours before surgery Ejaculatory Abstinence ≥72 hours

Eligibility Criteria

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Inclusion Criteria

* Male patients aged 18 years or older
* Histologically confirmed prostate cancer
* Scheduled for radical prostatectomy
* Able and willing to comply with assigned ejaculation or abstinence protocol
* Willing to complete preoperative questionnaire
* Willing to undergo transrectal ultrasound (TRUS) 12-14 hours before surgery
* Able to understand and sign informed consent

Exclusion Criteria

* Prior bilateral seminal vesicle resection or congenital absence of seminal vesicles
* Anatomical abnormalities preventing SV identification
* Hormone therapy within 6 months before surgery
* Inability to recall ejaculation history in the past 3 days
* Inability to follow behavioral instructions or TRUS protocol
* Severe anorectal disease or history of anorectal surgery preventing TRUS
* Cognitive or psychiatric conditions impairing informed consent
* Incomplete data or poor-quality imaging
* Prior prostate cancer treatment
* Belonging to a vulnerable population (e.g., minors, prisoners, pregnant individuals, cognitively impaired, etc.)
Minimum Eligible Age

18 Years

Eligible Sex

MALE

Accepts Healthy Volunteers

No

Sponsors

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National Taiwan University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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National Taiwan University Cancer Center

Taipei, Outside U.S./Canada, Taiwan

Site Status

Countries

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Taiwan

Central Contacts

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Yen Ho, M.D.

Role: CONTACT

+886933092258

Facility Contacts

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Yen Ho, M.D.

Role: primary

886933092258

References

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Medved M, Sammet S, Yousuf A, Oto A. MR imaging of the prostate and adjacent anatomic structures before, during, and after ejaculation: qualitative and quantitative evaluation. Radiology. 2014 May;271(2):452-60. doi: 10.1148/radiol.14131374. Epub 2014 Feb 1.

Reference Type BACKGROUND
PMID: 24495265 (View on PubMed)

Shin T, Kaji Y, Shukuya T, Nozaki M, Soh S, Okada H. Significant changes of T2 value in the peripheral zone and seminal vesicles after ejaculation. Eur Radiol. 2018 Mar;28(3):1009-1015. doi: 10.1007/s00330-017-5077-4. Epub 2017 Oct 6.

Reference Type BACKGROUND
PMID: 28986624 (View on PubMed)

Yuruk E, Pastuszak AW, Suggs JM 3rd, Colakerol A, Serefoglu EC. The association between seminal vesicle size and duration of abstinence from ejaculation. Andrologia. 2017 Sep;49(7):10.1111/and.12707. doi: 10.1111/and.12707. Epub 2016 Sep 23.

Reference Type BACKGROUND
PMID: 27660049 (View on PubMed)

Other Identifiers

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202507191RINA

Identifier Type: -

Identifier Source: org_study_id

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