Retro or No Retro After Surgery???

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I had been under the impression that the newer, less invasive procedures preserved normal antegrade ejaculation as well as full sexual function. Specifically procedures such as PAE, Urolift, REZUM, etc.

However, in just the past day or so, I have read here of at least one person having retro ejaculation from PAE, and another from REZUM. What's more, both suggested they were not alone, and one surmised that in the case of REZUM that people are being intentionally mislead by the manufacturer. 

I thought then it might be a good idea to put all the post-op experiences that relate to changes in orgasm, and/or any other change in sexual function, in one thread for easier reference.

In addition to the less invasive procedures it would be instructive to hear from those who have had TURP and Holep, as some have said they did have their orgasm preserved. There is also a TURP technique called Ejaculation Preserving TURP if anyone has had it. 

If at all possible, let's not debate whether retro is a big deal or not, as that has been talked about before, and could be a topic for another thread if someone wants. I think it fair to say on that score that retro orgasm is a big deal for some people and not a big deal for others. 

Jim

 

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  • Posted

    Hey Jim.  I will fight for mine .  With the PAE and the REZUM. there is a very low number that can have retro but most of the time being that the prostate is mad smaller you do not produces alot of seamen.  So if you do ejaculate you will have less they you did before.  So your orgasm may not be as intence.  With the urolift wihich I had over a year ago.  My orgasm is very intence and my ejaculation is good.  I can say that my orgasm is better now then it was before I had it done.  Who knows why but I will take it.  Have a good day..Ken
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  • Posted

    Jim  I don't know if this is the same Button Plasma turp.  The doctor has more control and they can stay away from the bladder neck and the ejaclatory duct so you have a better chance of not having retro  Ken

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    • Posted

      Hi Kenneth,

      My understanding is that the Button Plasma Turp and the Button Turp are the same thing. From what I read about Button Turp, and from what my urologist told me (he does Button Turps) there most probably will be retrograde ejaculation. 

      Ejaculation Preserving Turp (EPT) is different as its name suggests. From what I remember reading about EPT it's basically a regular Turp where the surgeon takes extreme care not damage the parts of the bladder neck that cause retro. You would think that all surgeon's would do this with a TURP but apparently this particular approach requires more time and thought and perhaps skill. Done in Europe from what I remember but you can google it or check out a thread I started on it last year.

      Interestingly, when I told one urologist that the main reason I didn't want a TURP was retro, he said something to the effect that he *thinks* he could do that if that's what I wanted. So apparently a Turp surgeon can make efforts to preserve ejaculation but most normally do not, nor do they seem to understand why preserving ejaculation is a big deal to some people. 

      Jim

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    • Posted

      Hi Ken,

      Here is are the results and conclusions of one study on ejaculation preserving TURP which the abbreviate as "epTURP". You can get the rest on Mescape or elsewhere. 91% chance of preserving ejaculation is a lot better than the odds two urologists gave me (0 %) !!! So why aren't we hearing more about this technique? 

      RESULTS:

      Overall, 87 and 63 patients were evaluated after 3 and 60 months, respectively. Antegrade ejaculation was preserved in 79 of 87 (90.8%) patients at 3 months. Significant improvements in maximum flow rate (+14.3?mL/s), micturition volume (+71.6?mL), and PVR (-59?mL; p=0.002 for all) were observed at 3 months. Micturition symptoms, as measured by IPSS and LQI, were also significantly reduced (mean change of 18.3 and 2.9, respectively; p<0.001). Improvements were maintained at 60 months. No serious adverse events were reported. Eight (12.7%) patients received a second epTURP due to the development of bladder neck scar tissue during long-term follow-up.

      CONCLUSION:

      Antegrade ejaculation was preserved with the use of epTURP with excellent outcome. Observed symptomatic and functional outcomes were comparable with conventional TURP. The results from this study underline the necessity of reviewing the old concept of ejaculation physiology.

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    • Posted

      Yes I have ask my doctor about this and he said it is also how big the prostate is. They have to be carefull and take there time Most of them just go in and start cutting away so they can get to the next one.  Most doctor tell men that they don't need to have a ejaculation because there not having kids.  We may not need it but we still what it.  Some doctors do care and talk with there patient  Take care  Ken  PS  I still would not not take that chance 

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  • Posted

    I sometimes don't think the Surgeons can give a true answer until they get in there to do the job and find out how serious the condition is. It will be a year next month since my TURP and I have incontinence and E/D plus Prostatitis and Thrush so I don't think I can get a lot more.

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    • Posted

      Surper  You got the jackpot of side effects.  I am so sorry.  Yes that is true that a doctor does not know what will happy. But if you have a Turp or one of the laser procedure it is a given that you will have retro.  Doctors down play retro.  They feel has we get older we don't need to ejaculate.  They tell you that your not having kids so it will be all the same but it 's not..  And it be real.  Has we get older we don't have sex as much as we did when we were younger.  But is that a reason to stop us for having that enjoyment. Even if I only have sex once a week I still want the intence feeling.  They tell us that you will still have a orgasm.  Yes you will but that is a text book answer.  Not all men have the same orgasm.  In principal yes.I can only tell you what I feel .  I was on Flomax and Rabiflo.  The first time I had sex after I statrted them pills did I get a surprise. I still got the built up but when the orgasm happen it was flat and there was no pleasure or after glow.  And with no ejaculation it was like I just did nothing.  I hated it and told my doctor I'm not taking these pills.  As for prostatitis all men have a form of it some worse then others I have groin pain sometimes and my penis get numb.  You can take a pill or what ever your doctor tells you to do.  All I know is that I feel that my ejaculation and orgasm is worth fighting from.  I would do any less invasive procedure before I would ever consider having my prostate cut out. But sometime you don't have a choice. Men before you do any procedure please look into it and get the information on it The pros and cons.  Also remember what work for me may not work for you.  All men are the same and we are worth the time.  Take care  Ken 

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    • Posted

      Very true comments Ken regarding age and whether you should have a sex life, but the one thing that worries me is that they say your Prostate is a hard place to "clean out" and I would have thought if you were able to ejaculate regularly then you are cleaning out this area. It worries me with E/D that everything is therefore stagnent and not moving and I can see my penis shrinking away. Now I can't even roll my foreskin back now that can't be right even for hygiene purposes and the pain in that area is terrible and now I wonder how they will perform a cystoscopy on Monday. The joys of getting old, and just keep taking the tablets !!.

      David

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    • Posted

      Hi Supertractorman,

      Were the incontinence, E/D, prostatitis, and thrush all a result of the TURP or were some of them pre-existing? Also, I'm assuming you had retro fro the TURP?

      Jim

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    • Posted

      They all came to a head after the TURP, but I think Sepsis really started the infections and Prostatitis as I seem to now have a poor immune sysytem.  Unable to reply on retro due to E/D.

      David

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    • Posted

      Hi again David,

      As your urologist about the problems you are seeing related to non use of you penis and prostate on Monday.

      Neal

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    • Posted

      Hi Neal, These are my first questions, but am going for a Cystoscopy but am wondering if they will do it as infections seem to be running wild and A/B's seem a waste of time. Will keep you posted, and just hope they may recommend a better A/B even if they did overkill to sort it out.

      David

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