Retro Ejaculation (RE) what to blame ?

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Hi all, I am 63 years old and have been suffering symptoms of BPH since 2010. I have been taking doxazosin which is an alpha blocker, (similar to flowmax, tamsulosin, etc. ) almost about the same time, starting with 2mg and ended with 4 mg in 2016. I also experienced retro ejaculation (RE). 6 months ago I discovered that I have urinary retention and the result was my kidney was backed up with urine, causing mild decline in kidney functions. Uro wanted to do TURP. I decided to self cath (CIC) instead, waiting for something better.

The issue here is every where I look, every thing is blamed for RE, including all procedures as well as all meds, without any explanations (mechanism) on how they should be blamed for. As far as I understand, the culprit here should be the prostate. It enlarges at the wrong place and squeezes the urethra and prevents the semen from reaching the penis during ejaculation. Having no place to go, the semen ended up going nowhere or going up to the bladder if there is less obstruction that way.

I did not have any procedures so I did not have any experience to share. However, all the meds try to is to relax the prostate. That should helps, not hurts the normal ejaculation. Right ? I feel that the meds have been falsely accused. Some people even stopped taking their meds and found out that RE did not go away. So they started saying things like "It may take months after stopping meds for RE to go away." Sure. This scares many men from taking drugs into suffering needlessly and/or having some procedures that outcomes are uncertain or could be worse.

My experience with doxazosin is whenever I increase its dosage, to 6mg or 8mg, RE is improved significantly, to the point of normal ejaculation. So I proved my point to myself. However, I keep wondering perhaps there is some better explanations or experiences out there that I am missing that any of you can share.

Another experience that I can share is that CIC also improves my RE. This makes sense since the catheter open up the obstruction and may keep it open for a while. During this time, especially very soon after the CIC, there is a path for the semen to reach its supposed destination. So for men out there who are doing the self cathing, reach out for the catheter before sex.

Hank

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  • Posted

    Meds can cause RE.  They think it is due to the alpha blocker inhibiting  smooth muscle contraction
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    • Posted

      Hi charlton, I saw it also in an article by the ncbi. In the same article, I found this :

      "In a long-term, open-label extension study, 30% of patients treated with tamsulosin reported abnormal ejaculation. In contrast, incidences of abnormal ejaculation related to the use of nonselective a-blockers, such as doxazosin, terazosin, or alfuzosin, generally were lower than 1.5%."

      I guess I am lucky to be taking doxazosin instead of tamsulosin. Are you taking any now ? Hank

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  • Posted

    Hi Hank,

    All I know, is this:

    I am on Tamsulosin... I get RE about 90% of the time (sometimes I do ejaculate normally)... however, whenver I stop the medication, the RE stops and my ejaculation returns to normal

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  • Posted

    The alpha blocker least likely to cause RE is Alfusozin. You should try that one - but if you're self cathing all the time, why take any meds?

    Also, you should know that TURP is an outdated procedure. There are other, far less invasive ones that require no anesthesia with a low incidence of RE, a much shorter recovery and very low risk of permanent side effects. YOu might want to get a full diagnosis, find out how much (could well be all, but isn't always) or your issues are a result of prostate size and whether one of the new procedures might fix your problem with much less risk than TURP.

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    • Posted

      Hi oldbuzz, I am still taking doxazosin to give my bladder more exercises and also to keep my retention lower between caths. I am looking into alternatives from TURP. Thanks. Hank

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  • Posted

    Hank, I did one of the new procedures that Old Buzzered is talking about and I had very good results. I did the Focal Laser Abalation of my prostate. I have no RE and no other side effects. Was back to great in 4 weeks of letting the swelling go down. This is a very precise and focused procedure done only by the Interventional Radiologist using real time MRI guided laser technology. They only remove the tissue causing the issue. (Hey, that rhymes!) In my case I was 65 with very bad BPH symptoms . My prostate was 125cc in volume with a large median lobe that caused retention. All my symptoms have improved greatly and I got my life back. If you want more close up detail you are welcome to personal message me and I will give you direct contact imformation so we can discuss. I think FLA is the best thing going right now. But remember all of these are symptom cures and nothing cures the actual condition of BPH. The gland continues to grow. I am trying to combat that with herbal things and slow the process of tissue growth. I hope to get 10 years out of the FLA and by then maybe we will have even better solutions.

    John

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    • Posted

      Hi John, I'm on and off this and don't take the time to read everything. I have seen FLA mentioned but didn't understand too much about it. Your results sound good. I've considered Urolift and rezum.How long ago did you have it done? Did a urologist recommend the procedure? Thanks, Kenny from MN

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    • Posted

      Thanks John, I followed your thread re FLA and am very interested. However, I am OK at the moment with combination of CIC and doxazosin. Who knows , maybe there will be another better solution like you said. Hank
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    • Posted

      Can you explain FLA better. Everything I'm reading about it is if cancer is found. I have BPH but it's not cancerous, so how would FLA benefit?

      Thanks

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    • Posted

      Warren and Kenny.

      I have shared my cell phone number with both of you. I am sitting here watching it rain. I am scheduled to play golf at 1 pm and the weather man says rain will be gone by noon.

      I can tell each of you about my journey to remove the symptoms of BPH from my life. It will take a while and I dont like to type that much. I have had BPH for over 8 years. I never would take the meds the Urologist want to give you. I do not want to have any sexual side effects. I am 65 years old. I am retiring soon. I have worked hard for 47 years. I was getting kind of bitter at the way life was turning out. I peed my pants about 3 times a day on average, I would get up to pee 8 times a night on average. My sex life was not affected by BPH and I was not going to allow BPH or the treatment of it to do that if I could help it so keep your pills was my answer. Finally, I was whipped about two years ago. I could not fight much longer. But the urologist who I went to all had answers that were worse than where I was at the time! So I decided I had to learn a lot more before I made my decision.

      First I decided I want to really understand all the componets of the prostate and what they did and then I will ask what each of the procedrue could possibly do to my life by effecting those componets in my glad. I want to know this before I gave my faith to one of these doctors. This did not take too long as the prostate is not that complicated a gland.

      Then I started looking at the possible treatments. Man is this a depressing subject. I looked at Uriolift frist as a lot of the initial work was done at UT Southwestern. I looked at  Uriolift, TURP, TUNA, TUMT, Greenlight, Holep, PAE, FLA, Rezum, and  iTend. This all took 20 months of depressing research. I visited with 9 different Doctors in Seven cities around the US.  My first priority in a treatment was, no sexual side effects.  I also did not want a procedure that entered my Urethra to be done for the procrure.  PAE and FLA were the two best canidates for achieving this objective. So I went deeper into these at that time. Also a fact that was odd is that a urologist cannot preform either of these. These are only done by and Interventional Radiologist. Also odd

      was that these two could not get insurance approval at that time. The urological associations and lobbies were really trying to fight the use of 3T MRI for biopsies because biopsy's alone  are now  a one billion three hunderd million dollar anaual revenue stream for urologist for just the biopsies done on men!

      OK, the rain has stopped maybe and I need to leave. You, or anyone else, are welcome to call me and I will tell you as much or as little as you want about the 20 months of research I did the reason I chose FLA. The procedrue I went through,  the Doctor choice I made and why, the recovery, the results I have had. I did this in mid December 2016. I am very pleased with the outcome. All my goals were exceeded. I am praying every night for the other men who are going with this treatement. And the others who suffer and look for some help. It is ashame we do not have a cure for this condition. It seems like we get old and they don't care. We just become a money grab for them.

      Sorry I have to go now. Call me.

      JOhn

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    • Posted

      Thank you John. I appreciate all you've said. No need to call, at least for now. I will be 61 in a couple weeks. I get up frequently at night, depending on my fluid intake. I was thinking Urolift, but a Urologist I know doesn't like that being in your urine stream. He thought REZUM is the way to go. Researching that is how I discovered this site. It's been a real eye opener. I will have look more into FLA & PAE. I'm at work now.

      Thank you,

      Ken

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    • Posted

      Hey KenMake sure you research anything you are going to do.  Why did your urologist say he does not like Urolift.  I had mine done 2 years ago and I have nhay problem Don't feel them at all.  I was not going to have anything that would cause me retro.  9 out of 10 do.  If he is sure it your proate and not your bler.  he urolift would ope you up to pee better.  FLA is a good procedure but not approve by FDA. And that does not cause retro.  Now with   it is also good but you will have a chance of decrease of your ejaculationor looit atogether.  I would try the urolift first to see if that helps.  No side effects and no long recovery  Take care  Ken

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    • Posted

      Hi Ken, re your night time urination :

      1. How frequent is it ?

      2. Are you on any medications, especially alpha blocker like flowmax, etc. ?

      3. Do you know if you have any retention ?

      Hank

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    • Posted

      Great posting John - clear as a bell. Bottom line: if your BPH parameters fit FLA and Doc K agrees to do it, go for it. Worth the cost. If not he'll recommend other procedures and TURP is not one of them. Always your decision.

      Thanks John.

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    • Posted

      Hi Ken, 

      I see you are new here so my two cents on FLA or any other procedure. 

      John, as you can see had a great result. However, if you take the time reading through the various threads, you will find a similar enthusiasm and similar great results for almost every procedure there is  -- be it PAE, Urolift, REZUM, Holep, GL and even our old friend TURP. You will read about how these procedures went smoothly and changed people's lives just like it did with John. However, you will also read, in the same threads, the other stories. The not so good stories about the same procedures, often with the same doctor. 

      The point is that it's often not the procedure, or even the doctor, but the condition of our own individual prostate and bladder going into the procedure. 

      I can go on and on, on this score, but just wanted to make the point at least how I see things, there is no magic bullet yet. FLA, while promising on paper, has a very short track record, and only three here to report on it. John did very well, the other two not as good as John. One is still on a Foley catheter. 

      I don't want to seem negative on FLA as I seems to have great potential, but I also don't want you or anyone else to be seduced by one great result, as in John's case. 

      As to REZUM, not sure that is ready for prime time either. We have had several cases of retro which suggest there may be more retro than the studies and promo literature suggest. 

      Jim

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