Background: Bladder outlet obstructions (BOO) are one of the major disorders in the aging male. The most common etiology of BOO in elderly men above the age of 60 years is benign prostatic hyperplasia, but younger men (< 50 years old) can also experience subvesical obstruction from a small but obstructive prostate. Surgical intervention (TURP) after failure of first-line treatment can achieve highly satisfying symptomatic and functional outcomes in patients with BOO. Retrograde ejaculation is one of the most common complications in benign prostatic hyperplasia (BPH) surgery. Surgeons are concerned about this complication when patients are sexually active. Objective: To evaluate the efficacy of ejaculation preserving TURP (epTURP) in relation to functional results. Patients and Methods: Thirty one patients with bladder outlet obstruction due to clinically diagnosed BPH were enrolled in our prospective study which was carried out at the Urology Department, Al-Azhar University, during the period from January 2017 to September 2019, undergoing (epTURP). They were evaluated for preservation of ante grade ejaculation along with the functional outcome of this technique after 1, 3, and 6 months of post-operative follow up. Results: The complications such as stress incontinence, urethral stricture and bladder-neck contracture were not recorded in our studied patients. Three patients (9.7%) did not ejaculate on follow up after epTURP at 1, 3, 6 months. We considered the cause of insufficient preservation of the safety area of the ejaculatory ducts.  In our cases, there was a failed case did not void after removal of catheter, and needed reintervention by traditional TURP. The decision of retreatment of the failed patient by traditional TURP was done by Al-Hussein Department after failure of epTURP to relieve BPH obstruction. We considered the cause as imperfect resection of the supra montanal tissue. Conclusion: The epTURP technique developed with the aim of preserving ante grade ejaculation for patients with obstruction manifestations due to benign prostatic enlargement, with failure of medical treatment to relieve that obstruction, and those patients who hope of preserving ejaculation for sexual pleasure, psychological satisfaction, or to gain pregnancy. The results from this study may underline the necessity of reviewing the old concept of ejaculation physiology.