Validated Assessment of Ejaculatory and Erectile Function After Unilateral “Z”-Shaped Bladder Neck Incision (ZANCLE): A Prospective Study Using the MSHQ-EjD Short Form and IIEF-5

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 (“Z” Anatomical Needle Cut Leads Ejaculation) technique using two validated patient-reported outcome instruments, the Male Sexual Health Questionnaire–Ejaculatory 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.