From the Rav’s Desk: TURP surgery in Halacha

TURP surgery

1. Question: 

Are there any Halachic ramifications to going through the procedure known as TURP surgery. What if the surgery causes a condition known as retrograde ejaculation, and due to it I can no longer have children naturally. Do I become a Baal Keri? Is this a problem of Kerus Shifcha?

Answer:

The issue of Petzua Daka and Kerus Shafcha: Indeed, any and all surgical procedures which are done to the reproductive organs are to be done with the consultation of a Rav who is expert in this field of Halacha and medicine in order to avoid unnecessary very serious Halachic shaalos which can prohibit one from remaining married. However, in typical TURP surgery, there is no actual deformation or snipping of any of the seminal vesicles or vas deferens but rather a simple cleansing and widening of the prostrate cavity to allow for smooth flow of urine. [This is unlike radical prostatectomy which usually involves the removal of the prostate together with the seminal vesicles, and the cutting of the vas deferens.] Furthermore, even if the above cutting were to take place, the practical ruling in this regard is that the person is not considered a Kerus Shafcha being that a) the deformation is in the internal organs and b) It is done because of danger and is hence considered like from the hands of heaven. This however is only Bedieved, as Lechatchila since there are Poskim who argue on this one must certainly first consult with a Rav prior to such surgery taking place. Now, regarding the TURP surgery, seemingly it does not make one a Kerus Shafcha at all according to any opinion, being that no reproductive organs need to be removed or cut, even though it causes one to become infertile due to the redirection of the sperm flow which occurs as result of damage to the bladder valve. Whatever the case, certainly Bedieved the person remains permitted to his wife, as understood from the ruling regarding radical prostatectomy.

Issue of Zera Levatala: One who has the condition of retrograde ejaculation does not transgress the prohibition of Zera Levatala neither when he is with his wife, nor when he later urinates. However, he should not perform Zera Levatala, even though no fluid ejaculation takes place at the time and the semen does not exit the body until he later urinates.

Baal Keri: Some Poskim learn that it is specifically the ejaculation which causes one to become a Baal Keri, and hence if one had intercourse without ejaculation, he remains pure and does not require any immersion at all. According to this opinion, by retrograde ejaculation, since there is no actual ejaculation taking place through the Eiver therefore, he does not become a Baal Keri.  However, other Poskim rule that it is not the ejaculation that makes one a Baal Keri but rather the actual intercourse, and hence even one who did not ejaculate becomes a Baal Keri and requires immersion according to the original decree and current act of piety. According to this opinion he would become a Baal Keri due to the fact and he had intercourse irrelevant of whether he ejaculated or not.

Sources regarding Prostate surgery and TURP: Chazon Ish Ishus 12:7; Tzitz Eliezer 10:25; 14:94; Minchas Yitzchak 2:123-6; 3:97-2; 6:141; Chelkas Yaakov 2:22; Igros Moshe E.H. 4:28-29; Otzer Haposkim 1 p. 164; Many Poskim and Poskeiy Doreinu in Encyclopedia Hilchatit Refuit 5 p. 424 footnote 376 that there is no issue of Kerus Shafcha; Many letters of Rebbe printed in Shulchan Menachem 6:15 that one must consult a Rav beforehand and avoid cutting the seminal tracks if possible

Sources regarding Zera Levatala: See Imrei Eish Y.D. 69 [no Zera Levatala if not fertile]; Shevet Sofer E.H. 1; Levushei Mordechai Gimel O.C. 51; Chazon Ish Nashim 36:2 [Zera Levatala is only if waste seed outside of body]; Tzitz Eliezer 14:95; Otzer Haposkim 23:17-7; Igros Kodesh 9:205 [questions if its called Zera without the prostate secretions added to the semen]; Encyclopedia Hichatit Refuit 3 p. 198

Sources regarding Baal Keri: See Rambam Hilchos Avos Hastumos 5:10; Har Tzevi 1:46 writes that from the letter of the law he is not a Baal Keri, although due to the doubt of the Mishneh limelech it is proper to be stringent; Beir Moshe 5:18; Aliba Dehilchasa 40:9 in Teshuvah of Rebbe Nissim Katzury; Encylopedia Talmudit Vol. 4 Erech Baal Keri p. 136; See Mikvaos 8:4; Chulin 24b; Encyclopedia Hilchatit Refuit 3 p. 190; Piskeiy Teshuvos 88:7; Sheyikadesh Atzmo 63:3; Mishneh Limelech Bias Hamikdash 3:3 explains that “Belia Sheiyno Gemurah without ejaculation becomes Tamei due to Baal Keri”; Igros Moshe E.H. 1:72 that a) The Mishneh Limelech rules he becomes Tamei and b) perhaps by Takanas Ezra we are more stringent as the entire reason of the Takana is so one is not found by their wives like chickens, and hence perhaps even if one is not Tamei, he requires Tevilas Ezra; Teshuvos Vehanhagos 1:124