REZUM--HAVE YOU HAD THIS DONE???????

Why does retro even happen? Damage to the bladder neck making the muscles weak? Wouldn't kegels fix that? I just dont understand why these procedures can cause retro, especially REZUM

Mike  I think that is still to high.  But if my UROLIFT did not work and had to pick another procedure I would have the REZUM but I would only have it done on the right side. The left has all the good stuff.  A couple of guys had it done that way and it worked great  Have a good night.  KEN 

a urologist told me most procedures change the way the duct to the bladder shuts, think of it like it's a plug, but because some of prostate cut away the plug does not shut tight any more, so semen goes into bladder.

Ok. Well kegels should fix that. Men shpukd do those anyway. Improves erection quality and orgasm intensity

It probably depends how much of prostate was cut away - kegels might help I suppose. I know someone who had Green Light surgery, did a lot of kegels and he said a lot of masturbating and eventually he was over retro.

Another cause of retro is if surgeon damages ejaculatory ducts

I would assume if he damaged the duxts it wouldn't come out at all. That's frightening to think like that. To be honest I got scared when nothing came out. But having the three previous I am hopeful I will be fine in a couple more weeks. I will update to let everyone know

best of luck Robert

Mike I don't think it has anything to do with the bladder neck when the REZUM is done because the steam goes inside of the prostate.  If you put the steam on the left side of the prostate that is where the ejaculatory duct comes in to the prostate. The steam does not know what is good tissue or bad so the duct can be destroy.  With all the other surgery doctor destroy the bladder neck and that is why it does not close.  You can read up on it on the internet.  Have a good day  Ken  If you don't want retro with the REZUM procedure only have the steam put in on the right side  

Ken thanks for the explanation of why Rezum is different - very interesting

No problem.  Also Stay away from the new 4 D Urolift  They started doing them in the UK.  They put 2 clips on the bladder neck.  That will give you retro.  If I have to have another UROLIFT.  There going to do it the regular way.  Mine is going on 3 years  Good night all  Ken

Another kind of RE can happen in a PAE. The blood supply to the prostate is somewhat blocked causing the prostate to shrink. The smaller prostate produces much less seminal fluid, but the sensations are all the same, and you wouldn't know there was any change if you weren't looking at the end of your penis as you ejaculate.

Neal

Thanks Mike! I'll keep you guys posted on updates

Actually, the ejaculatory ducts are on both sides of the prostate.

While directing ablation away from the ducts may be helpful, treating just one lobe should retain some antegrade ejaculation if that is an issue for a patient, although may lead to substandard treatment.

If you had a really big prostate, that could explain it, as they've found it takes longer to work with big ones. You probably have bladder issues too if you were retaining that much.

When I went 3 weeks without a drop (a record at the time) my doc thought my bladder might have been shocked and prescribed a course of Myrbetriq which definitely helped.

On a different track, if you have this many issues after Rezum, unless you have a high Gleason score, you might want to consider foregoing the radiation and just keeping an eye on it. You might end up with pee issues for a really long time for a cancer with a very small chance of causing harm.

I would have your doc measure your prostate size and compare it to prior to Rezum, to determine how much of your problem is prostate related. If it's the same size or smaller, your issue is probably your bladder. If it's significantly bigger (still swollen) time will heal it, but a temporary Stent would allow you to pee.

If you had >600 cc of urine in your bladder prior to a prostate procedure, you were in retention with overflow incontinence.

It would be likely that even removing your prostate you would continue to have retention.

Did you have preoperative urodynamics to demonstrate if the bladder had any activity before having a procedure ?

@JerseyUrology: If you had >600 cc of urine in your bladder prior to a prostate procedure, you were in retention with overflow incontinence.

It would be likely that even removing your prostate you would continue to have retention.

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They drained 1500ml out of me with a catheter (after a 400ml natural void) just prior to a six week rehab period of CIC prior to urodynamic testing which would determine if I were a candidate for TURP.

Urodynamics showed I had enough pressure left for a successful TURP but I decided to pass and self cathed instead. My retention at that point was still over 600ml. Three years of CIC bladder rehab later, most of the time I can do natural voids without retention. 

Point being that a retention of 600ml doesn't mean you are doomed to retention, even in a case like mine where the obstruction was never removed. The key appears to be bladder rehabilitation. But I agree, one needs urodynamic testing to make sure there is something to work with. 

Jim

I had a preop cystoscopy and an ultrasound to measure retention, but nothing called urodynamics.

Thanks to you and others for the responses.

Boyd,

Urodynamics more directly measures bladder function. Probably a good idea to get it done and preferably video urodynamics when bladder neck obstruction may be an issue and/or difficult to diagnose cases of incontinence. You may have to look around for a doctor that does video urodynamics.

Jim