Please Think Before You Do

I at least was told before holep, 95% chance of permanent retro. And I have it. I noticed that since I had it done last June my uro now advertises ejaculation-preserving holep. My prostate was bulging up into bladder base a bit, which causes the frequency issue. He said he cut a lot out the top. The top is where the ejaculatory blocking sphincter is. I have a hunch that ejaculatory preserving versions of TURP holep etc would be more likely to leave you with a frequency issue, as the price to pay. I suspect though that the slight stinging sensation that some men report after such procedures when ejaculating, is due to damage scarring to the ejaculatory ducts that feed into side of prostate section of urethra below that top sphincter. In which case maybe it can't be avoided as these procedures involve slicing out the existing urethra entirely in prostate area and leaving as a replacement a larger cavity/tube, the scar tissue inside of which forms the new urethra.

After having two prostate biopsies in three years because of elevated PSA numbers, my urologist determined that my problem was simply a very enlarged prostate . We discussed several options and he explained in detail what I should expect with each one. My main concerns were would I still be able to achieve firm erections and would I notice any difference in orgasms because of retro ejaculations. When we finally decided together that I would undergo Plasma Button Vaporization he told me my erections would not be effected and that retro ejaculations should be expected to some degree, but I would not feel any difference when I reach orgasms. And, now that I am 6 weeks post surgery I have to say the information he gave me was exactly how things turned outo. I have erections just like I did before my surgery and the retros have had absolutely no diminishing effect on my orgasms. Although it will be some time yet before I am completely recovered from the procedure I am very satisfied with its outcome. I knew what to expect right from the beginning.

It is sad to know from your post, Ken, that some men's partners have left them because of their individual results from their surgeries. That makes me think of the women who have had mastectomy and I'd hate to think that their partners would leave them because of that. Just like other men I do understand how we look at ourselves and sex, but there come times in most of our lives when we have to make decisions that might bring about significant changes. And, sometimes those changes include things like retro ejaculations. None of us wants that. But, if we are able to regain control of our urinary problems and eliminate the annoyance of constantly staking out restrooms I found that retros are something I can live with.

Another thing to think about, guys, is that when you read forum posts you are often reading about men who are struggling with sexual issues because of their surgeries or general health situations and I think we should all sympathize with them as they work through their individual issues. But, there are many more men out there who have gone through the same things we have and they have not shared their experiences. I'm sure some of them are anxious, too. But many are well adjusted to things as they are and are moving on.

If you are considering prostate surgery, TALK WITH YOUR DOCTOR! Insist on answers. If you aren't comfortable with him/her find another one. What you are about to have done to your body will have lifetime effects that you need to understand those effects fully before you agree to the procedure.

Good luck to all of you.

Thanks for your thoughts. Urology is still for the most part in the dark ages with a "gold standard" (TURP) that is often only gold for the doctor who collects the fee. 

Fortunately, urologists are now offering newer procedures such as Urolift, REZUM and iTind which are less invasive and where the ejaculation function is preserved in most cases. 

And IR's are also getting into the act with new procedures like PAE and now FLA where the ejaculation function is also preserved. 

I certainly hope this is the direction that urology is going, or in the case of PAE and FLA, where many IR's are going. 

While I think it's still too early to tell, the IR procedures seem to have the most promise but will have to pass some political and financial hurdles before they will be made available and affordable to the multitudes of men who need a prostate reduction procedure. 

One big hurdle will be the insurance companies who will want to hold onto as much of the paid premiums as possible, especially with the time consuming IR procedures.

For example, REZUM and Urolift take I believe under 15 minutes, while FLA takes hours, plus a much more complex skill set on the part of the surgeon. 

We can hope that the insurance companies will see the value of that added cost to men's lives but to be realistic they may not, at least in the near future. 

Meanwhile, hopefully the marketplace will be hard at work looking at newer and more affordable ways to reduce prostastic obstruction. 

It is men like you, and the internet as a whole, where ideas are now being shared patient to patient as never before, that will help make this possible by not letting urologists get away with calling something a "gold standard" when in fact it's far from that.

Jim