Aquablation and RE: did my uro lie to me?

Posted , 9 users are following.

Hi all, I was told that retrograde ejaculation (RE) is rare with aquablation (AB). My uro said that there is a procedure to 'spare' the part of the prostate vital to normal ejaculation and he did that. I went ahead with the procedure and now have RE.

As far as I have read, the issue is that the interior urinary sphincter is compromised.

I have also read that after the AB procedure, the surgeon manually trims out some of the wrecked. ragged tissue to make things smoother. In that sense, he agreed that AB is essentially followed by TURP. He says the AB procedure would cause the RE, not his clearing tissue afterward.

Everything I've seen about the robot/programmed part of AB indicates that the water part of the surgery would not cause any damage to the sphincter. All I can figure is that my RE had to be caused by his going in afterward and damaging the interior sphincter. Am I getting this wrong? Is he trying to dodge blame?

Thanks for any clarification on the 'water' part of the procedure.

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  • Posted

    How long ago was your procedure? It may take more time to a fully recovery.

    I was under the same impression; no RE due to no heat and programming specifically to insure no RE.

    The TURP loop would have heat, but he shouldn't have needed to go deep into your tissue for the clean up. My understanding is that you can successfully have an ejaculation preserving TURP, which essentially requires leaving the tissue untouched 1-2cm from the verumontanum (ejact duct area). If the aquablation procedure followed the same concept, any TURP/clean up should not have been performed in the area of the verumontanum.

  • Posted

    When did you have the AB? I have just had AB, so yet too discover if normal ejaculation is impaired. I chose AB in order that RE would be avoided.

    Cannot quite understand why your Uro carried out another procedure. Did you agree beforehand?

    The AB takes less than 1 hour to complete.

  • Edited

    I got my procedure August 2. In video on YT I have seen surgeons go in and manually smooth tissue. It's just difficult to see how far they're going. I am somewhat sexually active, maybe 5 times per week, so I would think if it were going to resolve, it would have by now. The uro just shrugs it off. I have all the kids I'm going to have, which he knows, so maybe that's why he is so cavalier about this.

    • Posted

      Important question If I may?

      does the Re you are experiencing detract from the sensation and quality of the orgasm?

      I am going to have AB shortly

      Thanks

  • Posted

    Saw this by Mayo Clinic.

    Long shot, some meds to try. Easiest to get a hold of is the cold medicine.

    Drugs to treat retrograde ejaculation are drugs primarily used to treat other conditions, including:

    Imipramine, an antidepressant

    Midodrine, a medicine that constricts blood vessels

    Chlorpheniramine and brompheniramine, antihistamines that help relieve allergies

    Ephedrine, pseudoephedrine and phenylephrine, medicines that help relieve symptoms of the common cold

    Let us know if it works.

    • Posted

      Those are the kinds of medications that gave my prostate fits. Alka Seltzer cold plus worked good for me for colds but would shut my prostate down. Claritin and Nasal spray did the same thing.

    • Posted

      From your comment, it sounds like it may work for his retrograde ejaculation issue. He will have that option available on an as needed basis. Currently, it sounds like he has no options.

  • Posted

    Thank you for the meds list. I will look them all up (I take a LOT of meds for other things and need to see about interactions). Honestly I had not even thought about using meds since I figured the problem is not organic but from surgery.

    Much appreciated.

  • Edited

    Hi, sorry to hear about your RE.

    I had AB in August 2022. My view from my own experience and reading accounts of many other people is that doctors do not do a good job of explaining either the risks of the procedure or how painful the recovery will be.

    I would get a second opinion if I were you. When I looked into AB I concluded that the risk of becoming incontinent or impotent was zero, or nearly so. However, I do recall that there was some risk of RE, maybe 5-10% of the cases. So, it is possible that your doctor made a mistake but also possible that you have been really unlucky. You won't know unless you have someone independent weigh in.

    I have a somewhat different problem from you in that I have scar tissue that has reduced the benefits of having the surgery. So, as you might imagine I think clearing out the scar tissue is a good idea. I have been planning to get a second opinion but I don't really want to have another procedure if it can be avoided.

  • Edited

    Seven weeks out from my aquablation today. After caring for traditional TURP patients as an RN years ago, I was surprised at how little discomfort I had post op.

    As far as RE goes, I have full blown ED, and don't want an implant so I can't speak to that. My Uro said RE will happen in 1 to 2 percent of aquablation patients. You are right about the cavalier attitude from urologists. One told me "you are not a porn star, or trying to have kids, so it doesn't matter". Another told me "Your wife will appreciate not having to clean up after you".

    Finally, some musings based on what I learned in my anatomy and physiology classes in nursing school. The prostate provides 70 percent of semen volume. Remove it and that volume is lo longer there. Also any TURP procedure including aquablation will leave a void below the bladder neck. That void will capture at least part of your semen volume upon ejaculation.

    • Posted

      Its not totally clear to me whether you are saying the ED was caused by the Aquablation?

      As for RE I have the feeling that my prostate is now so huge (137 CC) that it is causing partial ED an RE in my case! I wonder if anyone else can comment on this? to be very honest my enjoyment of sex has definitley diminished since my prostate as continued to grow over the last 8 years since I was diagnosed with BPH.

      Any feedback would be much appreciated,

      Im now thinking I dont have much to lose in going for Aquablation.

  • Posted

    Recently watch a doc review of aquablation. He mention that he has had patients who experience RE after the procedure, but 3 months later no longer had RE.

  • Posted

    Hi

    I just wanted to tell you about my own AB experience (which i had documented in this forum).

    i had my AB in December 2022. When i had sex after my operation, the amount of semen was very little almost to the point of 4-5 drops. Then shortly after that it got worse. Full RE. Nothing at all was coming out. But 5-6 month's later it was back to 4-5 drops again. A couple more month's later the amount increased. So..initially i thought i had total RE, but now that's not the case anymore.

    As someone else stated, most of the prostate tissue is gone, so is the amount of semen and that seems to be normal. So..what i am saying is, give it some time and it might come back, at least that was the case with me.

    The doctors really suck. They don't care about giving you information. No empathy. Nothing.

    That is why i was grateful to have found this website. I learned a lot from others experiences and i have documented mine, to help others.

    Wish you the best.

    • Posted

      Hi Thats interesting as I am down to a very small amount of semen and harder to reach orgasm and this is before any procedures! Ive had BPH for at least 8 years.

      So Im thinking there is not much to lose in going for AB.

      Comments welcome.

    • Posted

      Hi Jezzaman

      i had BPH for 3 years before i had my aquablation and i had no problems with erection/orgasm/sensation. After aquablation as i stated above , the amount of semen decreased , even after 6 months when it came back, it was never the same amount as before AB.

      And i am not gonna lie, the sensation/orgasm compared to before AB, is also somewhat less. I can maybe say around 90 percent compared to before AB.

      So AB definetely has an effect, but i take it. It is better than dealing with BPH.

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