Turp operation or laser ?or leave alone?

Hi.   How is your sex life?   Retrograde ejaculation seems to be a nuisance.   I am 50 yrs old and just had the procedure 2 weeks ago.  

I was lucky in not getting retro after the GL or after my recent bladder neck resection and removal of bladder stones. I would say it had no effect on my sex life at all. 

I am hoping to hear from BPH patients who have undergone treatment with the new Urolift procedure. It's much less invasive than TURP and recovery is in just days rather than months. needless to say I'm very interested but I would like to hear from Urolift patients. 

I called the company that makes Greenlight laser.  There is a 1 in 3 chance of retro.  You are one of the fortunate ones.  

Hi Camster,

I don't think it's the type of instrument used per se, but how the surgeon uses it. All the turp procedures either cut or burn away the prostatic urethra and prostate tissue. That is the area where ejaculate enters. Depending on how they cut around the duct where the ejaculate enters, it will then either continue down the urethra and out, or shoot up into the bladder, which is retro-ejaculation. It also may have to do with a person's plumbing. My uro said if I didn't have retro with the flomax (I didn't) he would preserve a ledge of prostate tissue above the ejaculate duct which would deflect the ejaculate down and out rather than up into the bladder. This is what he did, but it took a special effort on his part to do that. I'm guessing many surgeons don't make an effort to preserve the downward path of the ejaculate during the surgery and/or a persons plumbing is not conducive to it. 

Bob 

P.S. Camster,

For the past 4 months I've had unexplained nocturnal polyuria about one night in four. Most nights I only get up 3-4 times voiding about a half a liter into my bedside urinal, and can get right back to sleep. But about one night in four, I am up 15 or more times voiding more than 2-1/2 liters into my bedside urinal, getting up every half hour or so until 8AM. So far none of my doctors has a clue. I'd gladly exchange my nocturnal polyuria for retro if I could get a decent sleep every night. And I'm sure people with worse problems would gladly exchange my condition for theirs. Seems like there is always going to be something.

Regards,

Bob

 

Bob, Thanks for taking the time to respond.  When I use Flomax, I have no ejaculate which is maybe anejaculation.  I will see what my rectal ultrasound reveals on April 1.  I want to see for myself.  I don't have burning during urination, never had to get up numerous times during the night, but there is extreme difficulty urinating.  This could be outright obstruction or neurogenic issue.  Cystoscopy revealed median lobe enlargement.  I started to look into Urolift, but the enlarged median lobe may exclude me.  I'm awaiting for a doctor response on this.  Still looking seriously at prostatic artery embolization.  I haven't read of any sexual dysfunction with this.  There is a 15% non-response rate.  But it seems to have a nice upside and little downside since it is not going through the urethral route.  

I am using some alternative medicine stuff for help.  There are some things that do have some credibility and not bogus.  There may or may not be something for your nocturnal polyuria issue.  I'm open-minded for anything with healing capability.  Again, thanks for your time.  

@Bob120: But about one night in four, I am up 15 or more times voiding more than 2-1/2 liters into my bedside urinal, getting up every half hour or so until 8AM. So far none of my doctors has a clue.

-------------------

Hi Bob,

I'm assuming that with 2.5 liters at night, you're not urinating much during the day? 

I also had what could be termed a milder case of nocturnal polyuria, and tried a bunch of different stuff. Sometimes hard to say what worked and what didn't, but pretty much got it down now to having my last void before bedtime (it's a complete void because I self cath) and my next void anytime between 5-9am.

I'm sure the self-cathing helps a lot since I can be guaranteed a complete void before bedtime. Do you know if you still have a PVR or has that been resolved with the greenlight?

One of the things that seemed to help me was watching fluid intake while at the same time using urine dipsticks to make sure I was not becoming dehydrated. Some days my total fluid intake is just a couple of cups of coffee and a beer at dinner. I think this is helped by my diet which is relatively low in protein and fat, and very low in sodium. I notice that when I have anything high in sodium (slice of pizza for example) my thirst increases significantly and I take down more fluids.

The other thing I think that has helped is exercise. Something that gets your heart pumped up like a stationery bicycle, stairmaster, etc. After a really good workout, I notice I void more often naturally during the day with more volume.

Lastly, while I never tried them, I have heard that wearing compression stockings during the day might help as well as a daytime nap.

And, of course, there are a few drugs that are aimed at noctural polyuria if things don't get better on their own.

-------

Congrads on skipping retro on your greenlight. I read in one of your earlier posts that your surgeon made an extra effort in that regard. You also mentioned that he asked you if you had retro on Flomax. Wondering how the two might be related. In other words, would the flap he did for you be successful on someone who had retro on Flomax?

-------

Lastly, and unrelated, I think you responded to an earlier complaint/suggestion of mine regarding the confusing and unorthodox way these posts are arranged in the forum. I started a thread in the "Chatroom" on this topic, and if you or anyone else are also bothered by the way the posts are organized, you might want to read my post and comment. Hopefully, this thread will take you there, but if not, just go to "chatroom" and you should be able to find it under the title "Great forum. Very confusing posting structure".

https://patient.info/forums/discuss/great-fourm-very-confusing-posting-structure--338031

Hope things get better for you.

-- Jim

Hi Jim,

Thanks for taking the time to list all the possible things that could affect my urine output. Unfortunately I've considered nearly all of them. A couple of weeks ago I did an 11 day journal measuring all input and output. My input averaged about 2.4 liters per day. It ranged from 1800 to 2800ml during the 11 days. I think about a liter gets used up in respiration and digestion. During the day I voided any where from 800 to 1200 ml. I generally void less the day after an all nighter (I guess my body is dehydrated after). I had my PVR tested last month by ultrasound. My PVR was just 7cc so I empty completely. I don't have unusual thirst. I haven't seen any direct effect from what I eat or drink on good nights vs bad nights. I exercise the same every day, 5-1/2 minutes on an 11 degree incline manual treadmill before dinner. I have a whiskey and plain seltzer every night with dinner. I have 2-3 cups of coffee in the morning. The rest of the day is generally three 16oz bottles of plain water.

The way this is working is that anwhere from 1 to 6 nights in a row will be good. (By good i mean getting anywhere from zero to 6 times and getting right back to sleep). Then for no reason I get a bad night, up more than 15 times, voiding 2-12 liters or so. The longest I have gone without a bad night since Sept. was 10 days, the second longest was 6 days. The most bad nights I have had in a row was every other night, 7 out of 14 days.

Last week I took all sorts of blood tests and urine tests. Am waiting for the results. No way to know yet if this is an over active bladder issue (OAB-whatever that is) or a hormone problem dumping urine, or my heart telling the body to dump water. I'm on no meds of any kind. But if something works I'd take it. I think I'd take heroin if it worked-but I'd have to move to Portugal to stay legal. I had a problem in the bast with OAB medecine. Side effects were much worse than the OAB. Only other symptom is that on nights I have this condition I feel a fluttering in my bladder. It may just be the bladder muscles being overworked.

Regarding your question on retro and flomax. My uro said "if you didn't get retro from flomax, you won't get it from the surgery. My patients usually don't get retro.." and went on to explain why. I'm just guessing that if flomax causes retro, maybe your path out is somehow more crooked, or maybe the ejaculate is less forceful. So if you can ejaculate with flomax, then your ejaculate stream is stronger, and his procedure just provides a path for it to continue taking downwards. 

I guess if you don't get a reply from the mods, they have no intention to change the order of the posts. One thing that I use is the browser find command to look for a particular name. 

Thanks again for your reply.

Bob

typo.. that should have read voiding 2-1/2 liters on bad nights. If I voided 2-12 liters I'd likely be dead.

Hi Camster,

From what I have read on another site devoted to the Gat Goren method of PAE, (google gat goren method healingwell) an enlarged median lobe does not respond to PAE. As one of the other posters in this thread mentioned, his problem was due to the bladder neck. I had a GL laser 2-1/2 years ago but still had problems urinating (felt like I was peeing through a broken crooked pipe) until I had the bladder neck resection a year ago. I still have an enlarged median lobe protruding into the bladder (my uro trimmed it down during both surgeries, but never got most of it), so the median lobe may or may not be blocking the bladder opening. I saw where it was on an ultrasound. I also believe from my cathing days that the portion of the lobe that protruded into the bladder was about an inch in from the bladder neck, and my uro confirmed it was not close enough to block off the opening.

Bob

Just talked to the nurse from St. Louis University Hospital where they now do PAE.  Stephanie 314-577-6000.  She said they haven't had any problems with an enlarged median lobe.  On the other hand, I checked University of North Carolina where they do them and it is mentioned on their website that it has caused problems.  As some point, I will email Dr. Pisco and see if he responds.  He has emailed me back recently.  

Hi Camster,

I guess it depends on what is actually causing the blockage and symptoms. Do you have trouble or pain when urinating, and are you retaining urine in your bladder after voiding? Some men with small prostates are blocked, and some men with very large prostates are not. Getting up at night might not even be caused by a blockage, and I think is the symptom most likely not to be solved by reducing the size of the prostate. Urine retention after voiding and the inability to pass urine is the most likely to be helped,

The urologist and family doctor both say it is a smaller prostate, probably in the 30 to 40 cc range.  I will have a rectal ultrasound soon to get it measured.  Yes, many men with my size prostate would have no symptoms.  It depends where it is enlarged.  I looked at the website for RIA Endovascular in Denver where they do PAE.  They want a focused neurologic exam first to see if there are other problems.  I'm not sure exactly what that is but I will call them on Monday.  

There is a doctor in Pittsburgh that does PAE, Dr. Kevin McCluskey.  He is an assistant professor at Pitt.  He is going to try to get the PAE pre-authorized by my insurance.  I've had no luck in the past so I wish him the best in trying.

Hi Cam,

It's good they are doing testing before proceeding. In most of the cases I have seen posted, where procedures don't get the desired result (as was my case as well), it's because something else caused or contributed to the problem, other than what  the procedure treated. A perfect example is that women get LUTS will all the same symptoms of frequency, urgency, retention, pain, etc. And we know women don't have prostates, but they do have bladders. So all the symptoms of LUTS in a man can be bladder related as well as prostate relate.

Bob

Thanks for the post.  You are right on the money.  It can be a bladder issue as well.  Maybe this is what is being ruled out.  As always, thanks for your informative posts

Hi Camster:

We have the same situation.  I have a median lobe blocking urine flow.  

One doc said Urolift and a "partial turp" so I can retain antegrade ejaculation.  

But Urolift corparate said median lobe excludes me from the Urolift procedure.  

But this doc in Laguna said try Urolift - see what happens - then try "mini-turp."

What is happeniung with you lately,

Cheers,

J.

Yes do the urolift first.  No side effects.  Any time they do any cutting of the prostate your going to have a dry orgasm no ejaculation.  I looked up mini turp and it's the same cutting or burning the tissue away Think about it first.  I had my urolift done 4 month's ago and I'm great.  The first week is the worst.  You don't have a catheter with the urolift but I did. I was worried about peeing on demand.  I know about 4 guys that had it done and did not have a catheter.  Within 4 to 12 hours after they went home they ended uo back in the hospital and had to have a catheter.  They did mine when I was alseep it was much better.  Did not hurt...Talk to the doctor   Ken

Hi Chip,

I had PAE Nov 2013, about 25% flow improvement for a few months then slowly back to where it was before. Turns out I have a median lobe which reduces the effectiveness of PAE too. Interestingly the Prostate reduced from 53g to 38g so the PAE actually did what it was supposed to do - just doesn't get the flaming median lobe out of the way. I have asked my Urologist for Urolift (they do that as well, it's a University Hospital), but like you he has pointed out that Urolift may not work with the median lobe issue but he's still prepared to consider it. The alternative he's talking about is a "Limited TURP" just to resect the median lobe as the rest of the urethra appears to be unrestricted. I have serious reservations about any form of TURP given the sexual side effects. Not sure a Limited TURP is any less damaging from that perspective. Anyone got a view on side effects from just a median lobe TURP? PAE and Urolift procedures would without doubt remain my first choice options without the median lobe issue.

Hello Tim I would try the urolift before anything.  Which I did.  I'm great. There is nothing limited to a turp there cutting away at the prostate. They tell you there is no change but there will be. Dry orgasms for one. The doctors think that is ok.  Think about it before you do anything..  Take care  Ken. 

Hi Bob,

Any progress on the nocturnia. I just re-read your post and one thing stuck out where you said:

"Regarding your question on retro and flomax. My uro said "if you didn't get retro from flomax, you won't get it from the surgery"

Is the urologist talking about TURP? If so, I would definitely get another opinion, because from what I know you probably will get retro from TURP regardless of how you respond to flomax.

Jim

Jim Read up on the TURP You may not had any ED problem but retro is a given.  Anytime they cut away at the prostate you will have the orgasm but no discharge..  Ken 

Hi Tim:

Thanks for feedback.  

I have been to SIX urologists here in Southern California.  All have given me different suggestions!

One wanted to TURP right away.  Another taught me how to "Self Cath."   Another gave me Flomax.  Another said wait and see.  One said HOLEP. Another - in Germany - said EP (ejaculate preserving) TURP.  One said a "Mini-TURP."  Another said Urolift.  

WOW!!!  I guess that is why they call it "Practicing the ART of medicine." And these were all fancy med-school graduates.  Amazing.

But - just like having an attorney - the ultimate decision is the client's to make.  

The majority of docs - along with Urolift corporate office - said Urolift will not help a person with a median lobe - like I have.  So maybe I will be the test rabbit.  I have a median lobe.  Maybe it will work on me?

But this does suck.  Haha.  But I am grateful to have options.  

Can you imagine being a villager in the Amazoin with this problem?  What on earth do these poor chaps do?  Self-Cath with a stick everyday?

Hi Jim,

I still average about one incident a week with the nocturia. Had one last night. Voided 3000cc overnight from about 2AM to 7AM, going about every 15 minutes,  when it finally let up and I slept until noon. Thank goodness I'm retired. Most nights I only get up 2 to 3 times and void around 700cc, and get back to sleep within minutes after using my bedside urinal in the dark. I've consulted with a kidney specialist, urologist, cardiologist and my GP and they don't have a clue about the overflow nights when I void 2 to 3 liters in a 4 to 5 hour session. I no longer drink alcohol since my surgeries in April, and whatever I eat or drink doesn't seem to matter. I no longer take any meds, any vitamins or supplements. 

But to adress the other issue, brought up by Chip Bunker, I had a turp on my median lobe in April. This was after a second bout of hematuria (hemmoraging fresh blood that filled my bladder and clotted up my urethra) in a little more than a year. I had the Greenlight laser in mid 2012 which didn't remove the median lobe. A second Greenlight laser in response to hematuria at the end of 2013 removed a bit of the median lobe as well as bladder stones, cauterize my bleeding prostate and bladder neck, and resectioned the bladder neck. Both of these procedures spared the area that result in retro. I was really concerned about retro. In April, 2015 another hematuria resulted in a turp which removed the median lobe and cauterized a bleeding prostate. A second surgery two weeks later attempted to stop the continued bleeding and I was scheduled for another surgery to find and stop the bleeding a week later, when the bleeding stopped on it's own. This was all fresh blood, not just bloody urine. I had 6 pints of whole blood transfusions in the 3 weeks.

(I needed 8 pints during the Dec. 2013 hematuria and GL).

Since I don't take any aspirin or blood thinners, these heamaturia incidents were a mystery. The only other thing I could think of that thins the blood is alcohol so I quit drinking it in April. But my doctors said they don't think it's the alcohol but don't know what caused it. Obviously, however, the three prostate procedures must have chewed my prostate up and weakened whatever veins are in there.

Finally, my biggest surprise was that the retro I was so worried about happened and was a non issue for me. I still ejaculate, but the ejaculation goes into the bladder instead of out the urethra. I honestly had forgotten about it and my first orgasm about 6 weeks after the surgery felt exactly the same and I couldn't understand why I was dry. Then I remembered, it's the retro. For me the orgasms are indistinguishable, the orgasm is the same, the ejaculate is just re-routed, which actually can be a benefit in terms of tidyness.

Bob

Hi Chip,

I just posted a reply to Jim James, above, relaying my experience with a turp to remove my median lobe and retro 4 months ago. One thing I didn't mention is that removing the median lobe has increased my bladder capacity. The lobe as I saw it on an ultrasound was protruding into my bladder, and was seen as a dark shape covering about the lower 15% or so of my bladder. After it was removed, I urinate larger volumes. I know this because I use a bedside urinal ant night that has cc markers and I note the volume and times I get up at night. Due to about 20 years of bph, my bladder apparently built up a wall of muscle that reduced my outputs to about 200 - 250cc when I woke up at night needing to urinate. After the turp that removed the median lobe, I now go about 350 to 400cc per urination. So instead of getting up 5 or 6 times a nigh, I now normally get up 2 to 3 times. Using the bedside urinal in the dark, I get back to sleep almost immediately.

Everyone is different and there are many different outcomes, but as I said to Jim James, the retro that had me so frightened, turned out to be a non issue for me. To quote Woody Allen, "Every orgasm I have ever had [retro or not]  has been spot on."

Good luck.

Bob

Hi Bob,

Well first I'm happy to hear that the retro was a non-issue for you. In my case, after experincing retro on Flomax, it's one of the reasons I've put off an operation, but we're all wired differently. Ironically, I used to practice a sort of retro for a brief period in my twenties after reading about some Eastern sexual practices. One of the benefits was that you could recover somewhat faster between ejaculations. So, not all bad!

To your nocturnia, it does sound like a mystery. Sounds like they've ruled a lot of stuff out such as diabetes insipidous, and I'm also assuming your not dehydrated. 

So -- and this is just a layman's stab at things -- all that urine must be coming from somewhere because you can't constantly urinate more than what you take in. 

With my nocturnia -- which isn't nearly as bad as yours -- I've noticed that there may be a correlation to sodium intake. For example, let's say on Monday I eat a high sodium diet. What tends to happen is that the sodium forces my system to absorb the water and I will urinate less. But then let's say on Wednesday I come off the high sodium diet and really watch my sodium intake. Well, what seems to happen is now my kidneys start releasing all that retained water and now all of a sudden my urine output exceeds my daily intake. But the urine has to come from somewhere, so it is probably coming from the water retained by my body when I was on high sodium. 

Not sure if this has anything to do with what's going on with you, but you might keep a log of sodium intake or play around with sodium in your diet to see if it makes any difference. 

Beyond that, I see a kidney specialist if you haven't already, and keep looking for answers.

As to the median lobe thing and bladder capacity, is it possible that the operation simply changed your the point where you get the sensation that you want to urinate as opposed to the actual capacity? I ask because in my case I'm also naturally voiding only 200-250 on average, as you were before your procedure. But I know from previous urodynamic testing, plus from my self-catheriztions, that my actual bladder capacity is probably closer to 1000cc. It's just that I get the urge earlier now  which is good because if my bladder fills to over 400cc, I am unable to naturally void and need to use the catheter.

Jim

Hi Jim,

Thanks for the tip on the sodium. I'll keep that in mind. I pretty much don't restrict anything I eat. I've had 3 incidents of extreme nocturia in the past 3-1/2 weeks. Two were 2 days apart at the end of last month, and one was 2 days ago. The fact I went almost 3 weeks without an incident would seem to rule out food, although I did have Chinese food pprior to 2 of the 3 incidents, so maybe there is a connection to sodium, or seafood, or some of the spices in Chinese food. I did see both a kidney and heart specialist thinking there was some hormonal cause brought on by the heart or adrenals, but neither specialist could find anything. Obviously my body is flushing water during these incidents, but what the trigger is remains a mystery. At this point, I'm not too bothered by it. The only effect is I get 4 or 5  hours of sleep until noon, instead of my normal 8 hours until 9:30 to 10:00.

I never got retro on flomax, but I did get joint weakness and a stuffy nose that was troublesome. The thing about flomax is it stopped working within a few months of starting to take it. When it stopped working, al the side effects went away as well. If it had continued to work I probably would have taken it for years to avoid surgery.

I think you are correct about the protruding median lobe causing a signal to urinate, feeling full at 250cc's. The first time I went to the ER fro retention they removed 1400cc's into the cath, so my bladder definitely could hold more. But at 250cc's I felt a strong urge to urinate. I never tried to hold back and delay urination. Now I'll sometimes ignore the urge at night and sleep another hour. 2 to 3 times at night is my natural routine most nights now.

A relative of mine self cathed for years, then had a turp but had to go back to cathing a few years later because his bladder lost elasticity. In his case he never felt the urge to urinate, so he must have stretched his bladder to the point of incapacitating it. He's in his 70's and caths on a daily schedule of 3 to 4 times a day.

After 4 surgeries in three years for the bph and the hematuria, if it happens again I probably will opt to get my prostate removed.

Bob

You said: "...The fact I went almost 3 weeks without an incident would seem to rule out food, although I did have Chinese food pprior to 2 of the 3 incidents, so maybe there is a connection to sodium, or seafood, or some of the spices in Chinese food. 

--------------------

Chinese food is packed with Sodium. So, along my line of thought, what is happening in layman's terms is that after the Chinese meal, the sodium you ingest will hoard your fluid intake. Then, when you eat normally -- lower sodium -- all the water will flush out of your system, resulting in a very high daily output and nocturnia. Remember, fluid out equals fluid in plus whatever is burned off by perspiration, etc. So, if you're urinating MORE than you're taking in, that means some of that urine must be coming from past fluid intake stored in the body. 

To test this you could try a sodium restricted diet for a month or so, and see if that has any effect on the nocturnia. Alternatively, you could do a daily sodium log of all the foods you eat and compare that to any nocturnia events keeping in mind there may be a time lag of a day or so between when you have a high sodium meal/day and the nocturnia 

A very good web site to measure your sodium intake is "my fitness pal" with no spaces inbetween. The software does a lot more than measure sodium, but that's what I used it for when I was trying to lower my bp. 

Jim

Hi Bob,

I tried to post back with some ideas, but apparently it was intercepted by the forum software "for review" because I included a web site. But as an overview until my original post is released, given what you said, and the persistence of your nocturnia, I think reducing and/or tracking your sodium might be something worthwhile to look into.

Jim

Thanks Jim. I'll look for your post to be unmoderated, and try to link up future incidents with any changes in sodium intake.

Regards,

Bob

hi ken  i would like to know what the cost of the uro lift was, and what dr did it for you , thanks joe

Hello Joe.  It did not cost me a thing.  My medicare paid for it.  Was suppose to cost me $200 dollars for the surgery center but they never asked me for the money and never got a bill.  Had it done in April of this year.  My erologist name is Dr. Patel.  Florida Hospital Group.  Ken  

Hi Bob

I am 53 year old with BPH which appears to have a caused an episode of AUR. I am now catheterized and booked in for Green Light Laser.

Your experience is very interesting and i am keen to find out more.

I would also like to know which Urologist you used as he sounds like the kind of guy one needs in this situation! Not sure if you are allowed to mention names here though? THere will be many other people interested in your post on this Forum as well,!

Hi Jezzaman,

I'd be glad to answer any questions. Curious to know if you plan to have the GL with your own urologist next week or plan to switch doctors. My urologist has offices in Staten Island, NY and Howell, NJ. His name is Dr. Vance Moss. He is also a combat surgeon and served in Afghanistan. He did both my GL and my turp. Personally I think the turp got better results. But it is only about 6 months since the turp so it's probably to early to tell. Most issues pop up after about a year.

Hey Jezz.  Did they offer you any other option.  hope you red up on the Green Light.  The side effects they tell you that all will be the same.  Have you ever had a dry orgasm.  I had them with some meds that I was on. It's not the same. With the green light that is a given.  There are some many other procedures that can help you and don't  do that to a man.  I'm 60 and still love sex and still enjoy that feely.  It up to you to make your pick  Enjoy all you can   Ken

You mentioed in the other thread "I certainly don't like the idea of  RE at all!". You do realize that with Green Light, you probably will end up with RE?

Jim

Hi  Bob

The DOc has suggested self catheterization intially and is booking an GL operation; however he reckons there is a 2 month waiting list so I have time to consider all options and see how I get on without an indwelling Catheter which is where Im at currently and sick of it! Now scouring the posts here to glean as much info as possible.

Hi Jezz,

My uro performed 2 greenlight lasers on me and a turp. I felt the standard turp was a quicker and less painful recovery. For me the retro ejaculation didn't matter. I was very worried about it but it feels no different to me. An alternative to the indwelling cath is to self cath several times a day. I learned to use the self lubricated hydrophillic speed caths (about $1 each) and used them for a time. Once you learn it, it is fairly easy and painless. to use.

Hello Jim

Yes I do realise this, so am now considering the other options such as Urolift and PAE. But I am in UK so its very different over here, although I do apparently have the choice to go wherever i want for the procedures.

Having read extensively all the posts I am coming to the conclusion that the only permanent and fully effective solution if you have retention due to BPH is probably GL, Holep,  or TRaditional Turp.

As regards RE it seems that you may be able to avoid this if the surgeon is clever enough and can leave a flap of the Prostate to prevent Semen flowing back into the bladder according to some posts I have seen. Are you still happy with your self cathing?

Posts here aside, ask your surgeon what per cent of his patients get retro. And also ask them, what per cent of their patients who don't get retro have to be reoperated on and then get retro. And then ask yourself, am I willing to live with those odds. 

As to "Am I still happy with self cathing", a better question is *was* I happy with self cathing, because as I mentioned I really only do CIC very occasionally now, maybe once a week. 

Hopefully, tomorrow (Monday) my post will be out of moderation and some more of your questions will be answered on CIC. I strongly suggest you give it some consideration and ideally a decent trial -- 3-4 months. You can always stop self cathing and get an operation, but once you get one of the operations you're contemplating, you're pretty much stuck with some of the results for life, such as retro. 

Jim

Jezz  Hello  Are you being force into the Turp.  I know I have read others post from men that are in the UK and some of the Doctor have told them to take it of leave it.  Please before you do anything try whatever you can before they cut at the prostate.  Once they do then other problems will come.  And it may not work the first time and have to do it again.  Reto orgasm may be the same in some men but when I had them from meds I hurt for 45 minutes after.  It was very uncomfortable in the bladder.  Take care and please look up other procedure  Ken

Hello Jim

yes I am definitely going to give CIC my best shot, but thinking of the practicalities; for example I am just about to go to the pub with a mate (the same one that i was drinking with when I got the AUR!!)

i am only able to tolerate 1 piint of beer currently but that is no bad thing.

I have the Foley cath in and a leg bag. But if I was self cathing then id have to take a medical kit bag to the pub; is it really viable and safe? Id worry about keeping it sterile in a typical pub toilet scenario. But i shall see i guess.

THanks Ken for your forwarnings I am researching like mad and reading as many posts here as possible.

I am not being forced into anything, but I have had 2 serious episodes of AUR now and it is no fun at all!!  Currently feel "safe" with an indwelling Cath and leg bag!

J

Jeremy

It's no problem....I was reading your post to Jim.  If you can get used to  cathing yourself maybe you could get rid of the indewelling one.  I have a lady friend that has been using a catheter for over ten years.  She told me it was hard at first but she got use to it.  Of course she carrys hers in her bag.  They do make some for men that go in you pants pocket and just carry alcohol wipes. Wash your hands before and after.  If I had to do it I would think about it..Take care  Ken 

When I went out drinking, I'd CIC at home just before. Sometimes that carried me till I got home. Sometimes not. But after practice and experimentation, I could be in and out of the bathroom in under 2 minutes, faster than it used to take me to do it naturally, dribbling and all!

My "kit" was simply my cath and two small bottles that could fit in my pocket. One, alcohol hand cleaner. The other a spray antispectic.  Actually I didn't even need the hand cleaner, since I never touch the cath expect for the plastic rim. All in all, my procedure is quite sterile, but if you read the literature, all you need is what is termed a "clean" procedure, not a "sterile" one.

As to the cath itself, the one I use doesn't bend well, so I would carry it in a backpack. Alternatively, you could use another type of cath that does fold up and keep it in your pocket. At one point I was considering have a special pocket made so I could carry it in my pants unfolded, but never got around to that. 

Jim

Mr. Jim James:

You are my SELF-CATHING HERO!!!!!!!

Everyone with "urine-flow-difficulties" should learn how to self-cath.

And your info is INVALUABLE!!!

Thank _od for these forums - and for people like you.

Gratefully,

Chip

Well, thanks Chip. Not sure if I'll make "The Avengers", but...

I see my post to "Jezzeman" finally came out of moderation. In case you missed it, or for anyone else interested in CIC (self catherization) it's in this thread: 

https://patient.info/forums/discuss/self-catherization-an-alternative-to-turp-greenlight-holep--336874

Feel free to reply here but probably better in the thread above to keep the self cathing stuff in one place.

Jim

 

My post on self-catherization that hopefully will answer some of your questions finally came out of "moderation". You can find ad reply to it in this thread here:

https://patient.info/forums/discuss/self-catherization-an-alternative-to-turp-greenlight-holep--336874

Jim

Someone please help me. I had the TURP operation 6 years ago in December of 2009. I have had problems ever since and can't seem to find any help.I can't sit down properly and have a terrible discomfort in that area ( the perrenial). I remember the Doctor up in Kingston, New York having a terrible bedside manner. My problem is pain and a feeling of the whole perrenial area being out of whack. I do not know how much longer I can take it. Sometimes I feel like taking a gun and blowing my brains out. Can someone tell me PLEASE what could have happened. Is there any hope? Do I have to live like this for the rest of my life? I have been to every Doctor I can think of and have to live like this every day.  

Steven,

What kinds have doctors have you visited and what have they said? Have you had any scans of the area like a CT scan or MRI. Have you seen a good neurologist, like the head of neurology at a teaching hospital?

Urologists can be pretty worthless when things go wrong outside of a very narrow scope? Neurologists deal with the spine and the nerves of the body. SInce all pain originates in the nerves, they are the best in diagnosing pain. I had unexplained stabbing pains in my upper thigh about 20 years ago. I went to a neurologist and in about 3 minutes told me I had Meralgia Peristatica. He did follow up tests to confirm, but they confirmed his original 3 minute diagnosis was correct. Apparently a nerve that goes from the spinal cord through the pelvis to my upper thigh (right about where my pants pocket was) was very sensitive to pressure and would fire when anything was in my pants pocket. The onlyway to stop the pain was to sit down and pull my knee into my chest to free the trapped nerve. AFter about 20 minutes of walking I'd have to pfind somewhere to sit and pull my knee into my chest for about 5 minutes until the pain stopped. His prescription was to never carry anything in my right pants pocket. It worked and it's been about 20 years without any pain in my leg.

Try a neurologist for the pain. 

Thanks Bob,

   I will try this. I am going to the University of Gainsville at Florida, but I am seeing a Urologist. I will see if they will transfer me to Neurology Dept. I hope that is the answer. I am going out of my mind thinking I am the only one with this condition. Each day is a struggle. Please keep in touch with me. I have to have someone to talk to. i don't feel like the same person I used to be before the operation. The doctor ( who did the procedure ) put me on flomax for a week, and then went ahead and did the TURP. I wish I had never had it done. ??? 

I had two Greenlight laser turps, June 2012 and Dec 2013, and a regular classic turp in April 2015. My prostate grows like crazy. It's presenty over 200g. and I'm taking generic Avodart (dutasteride) to try to shrink it. But I never had ongoing pain. Urologists seem to specialize in bph, and prostatitis, and not much else.For chronic non-bacterial prostatitis, there's nothing they can do. For bacterial prostatitis they have anti-biotics. For bph they have flomax and dutasteride and laser or traditional turps. Once these options are exhausted they are at a dead end. Good luck with the neurologist. Hopefully he can find the source of the pain and then go from there.

Bob

Thanks Bob,

  It's good to find a friend on here. I had the traditional TURP and I was only 59. I had it because I guess I was scared. I had just come out of a relationship. A week after she broke off with me , I started to get the sensation that I couldn't sit down. It felt like I was sitting on a golf ball. My prostate was very swollen it seemed. I had all the std tests done and had negative results. The problem was I was already having prostate problems and my urine flow was at a very minimal; as well as around 5 bladder stones and quite a few kidney stones. I was desparate. I found this urologist and he did all the tests. It was also around the December holiday season. He called me in one day and had me take a urine flow. When I had finished he told me I had the urine stream of an 85 yr old man. Because it was the holiday season, he offered me a window and said he could do the TURP on the next day. I didn't  mind the peeing bad, I just wanted the swelling and pain to go away, so I took him up on his offer. I regret the decision I have made as I have been having ongoing problems with this ever since. I wasn't given the choice of Avadart--just the TURP.

   Now tomorrow I will be going to Gainsville. I will see the Urologist there and suggest he send me to the neurologist. I'm frightened about all the decisions that I have made and have been living in misery for six years. I am so grateful for the friend I have made on here.

   Steve 

I was 65 when I had the first Greenlight. I was going into full retention at night. I went to the ER and they cathed me and removed 1400ml of urine. After that I learned to self cath. I was going small amounts about every half hour all day long. The GL did open me up and improve my urine stream but was a difficult recovery of pain when I urinated and bleeding for about two months.

Before the Greenlight I also had that feeling of sitting on rolled up sweatsocks. It was annoying but not painful. 18 months after the GL, I had uncontrolled hematuria (bleeding fresh blood from the prostate). The fresh blood clotted almost immediately and blocked up my bladder completely. I was in hospital for a few days on an irrigating 3-way cath and then had a second Greenlight Laser. This time my urologist removed more prostate tissue, found and removed a bunch of bladder stones, widened my bladder mouth, and stopped the bleeding. After another 2 month recovery my stream was good again, I was not retaining urine and could go about 2 hours between bathroom visits.

15 months later I had a second hematuria. About a liter of blood collected in my bladder and clotted my bladder shut. Again I was in hospital on the 3-way cath and this time my urologist used the classic turp to remove prostate tissue from my median lobe and stop the bleeding.

I needed 8 pints of blood transfusions on the first hematuria and 6 pints on the most recent one in April 2015. I started on the dutasteride (generic Avodart) three months ago, when I asked my urologist to prescribe a sonogram to measure my prostate, and found it was over 200g. in size. The dutasteride seems to be working well. My stream is stronger now than ever, and I'm voiding 300ml  to 500ml at a time (I have a urinal with ml markings I use at night and note the output).

I haven't had the sitting on a bump sensation since after my second greenlight. I never had the constant pain you speak of. Good luck. I know it's easy to panic when you are in an unexplained medical situation that gets no better. But sometimes it can be resolved, just not as quickly as we would want it to. It's been 4 years and three surgeries for me, and I wish I would have taken the Dutasteride at the start, but it seems to be working well now. For how long is anybodies guess though. I can't go back in time, but it's also possible I needed those three surgeries anyway. No way to know.

You should have never let him talk you into it.  Once it done it done.  Look at Bon he had 3 and still has a problem  Ken

Steven you should have not rest into it.  And that doctor should not have offered it like that.  Thay make money doing a turp.  It's to late now but next time think and take some time to make your mind.  Take care and I wish you all the best  Ken   

There weren't many alternatives when Steven had his and when I had my first Greenlight. When a person is in retention the urine has got to come out somehow. Flomax no longer worked for me after a few months. I was waking up in retention having to go but not able to around 3AM every night. The only alternatives at the time were self cathing and a turp or laser procedure. And I haven't been in retention since except for when the two hematurias filled my bladder with clotted blood and blocked me up.

I am so sorry for you guys for what your going through.  I'm glad there are more to puck from now.  I would never have a turp or laser.  I would have had to self cath. I don't care for catheters but I would have done it....Take care guys  Ken.  I was on Flomax and a few others did not care for them 

Am a little tired tonight !! Will post again tomorrow.

No problem  Just rest  Ken

Bob & Ken,

   I went to the Urologist yesterday and went through the whole ,nine yards. they did the ctscan and he said there was a little inflammation there where the bladder meets the prostate, but it shouldn't cause the issues I'm having. The dr. said it was caused by the overgrown prostate Then he did the cystoscopy and everything in that area looked fine he said. The TURP looked well done and clean. It's funny, though, because my prostate was only 60 gr when they scraped it and it was causing me such Urinary problems, a bladder retaining more than half of my urine, 6 bladder stones and so on.

   So he suggested that I try pelvic floor physical thereapy. I told him that I would, but also suggested that I see a Neurologist for my own peice of mind to see if there is any nerve damage or whatever to the area. I didn't post last night because I was feeling sort of ok when I went to see the Urologist yesterday but then again it started up again last night when I was sitting down watching tv. I don't know if the physical thereapy will help, but can only hope so and take each day at a time. Any suggestions would be appreciated.   

   

      

I still feel bad that you had a turp and look your still having a problem.  With your prostate only 60gr.Why did they even do it.  I would go to another doctor maybe it has something to do with your bladder.  The inflammation is that mucles they distroyed when they did the turp.  That is why it causes dry orgasms.  Of course he going to tell you it looks good because he did it.  I hope you fine out soon so you can relax and get on with your life..Ken  

Hi Steve,

The good news is that the turp did cure your urinary problems and you got your bladder stones removed (like I did). From what I understand, it did not address your issues with feeling like you are sitting on a tender lump. Not being able to urinate and retaining half your urine had to be dealt with, and at the time the turp was the only way. The turp basically is good for retention and inability to urinate, but won't solve other problems. I think you should go ahead with the pelvic exercises and also see the neurologist. If the pain is not being caused by the prostate, it amost has to be due to nerves firing in the pelvic floor area.

I wonder if the pain could be coming from your testicles or colon, or even some sort of cyst in that area? I do believe the neurologist is likeley to recommend other tests to track it down. Good luck and keep us posted.

Bob

In spite of everything else, I do not want to have the retro- ejaculation.

Didn't you get that when you had your turp? I got it after my turp last year and didn't even notice it.  Was a non-issue to me.

I'm with you.  But you had a turp done you should be having retro.  When they do it they mess up the muscle at the base of the bladder that is what stopped the sperm from coming out.  I will never have anything that will stopp me from ejactulating.  Had them when I first say my urologist. He changed me after that.  The orgasm were not as inteanse and I felt like there was something and and in complete as a man  Ken 

Steve there is a treatment that there working on.  Taking a decongestant.  Sudafed or pseudoephdrine.  I guess it's worth a try..  Ken 

The psychological aspects of this are devastating. Sometimes feel like I just want to throw the towel in and just give up. Had a very bad day today. Lots of pain and discomfort and on top of this , they don't know what is wrong. I don't know what tomorrow brings. Not the man I used to be. Feel depressed all the time. Please my friends don't abandon me. Have no support from anyone!!!  Wish I never went to that Dr. up North. His name was Richard Chazkel. If only he'd known what he's done to my life. I used to wake up with a smile everyday and then I met that girl and Dr.  Chazkel.  Wish somehow the Good LORD would bring me out of this nightmare and show me the way. Feel like I did something very wrong by having this procedure done and don't know how to reverse it. The muscle spasms are quite often now and continuiosly bother me. Would Love to feel the way I once felt.

   Steve

    

Pleae don't give up.  I would go to another doctor and see if he can give you something.  I wish you were here in Florida I would send you to my doctor he would help you.  I know it is very depressing but it's over now you have to see what you can do to fix the problem.  They can give you something to relax the bladder.  Just try to fix one problem at a time.  Take it day by day.  E-mail me private if you just like to vent and talk I'm on the computer most nights  Just relax my friend if you can  Ken

I live here in Florida, Ken. I live in Palm Coast !

I live in Orlando. 

I tryed calling the doctor up North who originally did the TURP to see what these muscle spasms are all about. He wouldn't talk with me !! What's a person to do?

I would keep calling him or write a letter and and ask what the hell did you do to me.  He rushed you into it.  You should have tryed something else.  If he will not help see if you can get a hold of a urologist in your area.  They should be able to give you something to clam your bladder.  Never had any problem with the urolift. Did you get my other reply about trying to stop the retro orgasm.  There are some articles on it that if you take a decongestant it will help to close the bladder so the sperm go out not in...I don't know but it may also help with your problem.  Read up on it    Just keep trying  Ken

This Doctor was evil, Ken. When I was in the admitting room waiting to get the anesthesia, he came over to me for me to sign the papers. I didn't have my glasses so it took a little time for me to see them; then he grabbed them out of my hand and said to me "Is this the best you can do". I told him the writing was a little sloppy because I couldn't see very well at the time. Then I was out and there was no turning back.

   A couple of weeks later, I went to my regular family DR. and told him who performed the TURP on me. When I told him him it was Dr. Richard Chazkel, he put his hands in his forehead and said to me " Why did you go to see him?" "He doesn't know what he is doing." He told me as to how this Dr had hurt a woman before me and she almost brought a lawsuit against him.

    I do remember after the procedure was done, I tried to sit up in the bed, but had a difficult time like a" pinching" feeling in the perrenial area. I thought to myself as that this might be normal as I just had a procedure done and it would probably go away within a matter of time.  Well, it's still with me. Not quite as bad as it used to be, but it is still there.

    I have tried to call this Doctor a number of times, but he will not return my calls My question to you Ken or Bob or anyone out there who reads this is "This being the Dr. who did the TURP. Is he the only one who can possably know what is causing my problems or would or could another specialist help me so that I Can or Could get my life back again. I am scheduled to see the Neurologist and Urologist again at the University Hosp. and hope they can give me some answers. I so much want to live again, but am starting to give up on hope.

 Your friend,

  Steve     

In many States you can check out any physician before you see them. Simply google in the State the doctor practices in and next to the State add "Physician Profiles." After you put in the name of the doctor you will get a lot of of information such as his or her medical education, internships, his or her medical specialty, how long in practice and whether or not they ever had any malprcatice claims against them, plus much more.   Good luck.

Steve,

Your original doctor probably doesn't even remember your case. He could be a  nut or a drug addict or just a poor surgeon. Even if he does remember making an error he would never admit it. Best to move on. Good luck with the neurologist and new Urologist. Let us know what they say and propose. Do you feel pain all the time or just when you sit? How bad is the pain on a scale of 1 to 10? Have you used any pain meds or gotten any therapy? What does your wife make of all this? Whatever happens, never, never allow yourself to feel sorry for yourself. It can only make things worse for you mentally.

Bob

 

I think he is not returning your calls because he knows he did wrong.  You were to rushed.  Another urologist should be able to help you just tell him what happen.  I am so glad my urologist is a nice doctor I have never had a problem with him..  I am having a implant repair on wednesday at 2 should be home by 5.  I know I will see him before to ask questions or concerns. I was just thinking wht was he having you sign the paper work where was the nurse? Did you try the decongistent for the retro orgasm.  Read up on it.  It has help some of the men.  Talk later buddy  Ken 

Hi Bob,

   I will try. It isn't easy. I don't have a wife. I'm not married. I will see what the Urologist and Neurologist say. Pain and DISCOMFORT most of the time now.Especially when I go to bed at night. Pain level around an 8. I went to see my Gastroenologist today and he prescribed something for me that begins with the letter E that may help my muscle spasms down in my private area. I have discomfort upon standing and sitting. No pain meds, although I am seeing a Holistic Dr.who is helping me a little bit. I am taking cranberry extract, Resinall K, Medix 4 Life CNT (ml01), Thiosinaminum, Synergy One and Liquid Biocell.

Hi Ken,

    I will reply later. Thanks for being such a good buddy.

Steven that doctor really did a job on you.  See anyone you can but not that a.. hole.  Ken

No problem anytime  Ken

Hi Steven I hope the new docs will help you. A possibility is you have something called prostatodynia, or chronic pelvic pain syndrome (CPPS). It is treated with muscle relaxation techniques like the kegel exercises. 

If you google it, you can see whether the symptoms match yours.

Another less likely cause is chronic prostatitis. I have had non-bacterial chronic prostatitis for years, but I've never had pain, though some people do.  If your urine is clear and doesn't have a foul smell, than you don't have bacterial prostatitis, but may have non-bacterial prostatitis.

I know it can take a long time to get to the root of your medical problems. I have done many hours of research and googling and eventually do get to the bottom of things. But there is always another road if something doesn't work. All my doctors are those that will discuss my questions and issues with me, rather than shut me up and tell me what to do. I always go in with a lot of research and am prepared with questions to ask. SO I feel like a participant rather than just a consumer in myt medical issues.

If all  else fails, there are centers that deal with chronic pain, and it may be worthwhile finding one, even if your doctors have not yet uncovered a cause.

 

Hi Ken

   It has been tough. Sometimes I feel as if I am all alone in the world. I'm not all alone in the world; am I, Ken?  Last night I was starting to feel better. Today it is back again. Worse than ever. I wish I could put a finger on it so that I could be myself again.

   I do hope there's a light at the end of the tunnel.

Steve your not along If you like to chat anytime let me know.  Ever if you just like to let off steam.  Talk to me.  Having a implant fix on Friday.  I had a urolift done in April of 2015 and in December had a very bad prostate infection  I was on ciprofloxacn 500MG 2X a day for a month.  The infection messed up one of the implates.  Will get it done on fri.  I am also having him check my prostate and bladder whiles he's in there.  Have been having kidney and prostate infections for 13 years.   I'm just getting tire of them.  I trust him to tell me the true.  Then we will go from there.  He will not anything with my permission.  Talk later  Ken

I love your humor amid the misery...

Hi, the urologist put me on Tamsulosin (Flomax) and that gave a taste of retrograde ejaculation. You orgasm and surprisingly (compared to my younger years) almost no fluid is coming out. Meanwhile I went off the medication again. Anyways, you can have normal sex, the intensity of the orgasm is there. The only difference is the partial or total absence of fluid. Seemingly more an emotional issue than anything else, except if you want to procreate.

Emil.  Your one of the lucky one sometimes there is no feeling at all and some men just give up sex because it is not the same anymore.  I was on flomax and rapaflo for 2 weeks.  Did not know much on it .  I was watching some porn and was having a little fun.  The build up was great and when the orgasm hit it went flat. No feeling at all not a thing.  I did not take another pill.  Talk with my doctor and had a urolift.  Now at 61 my orgasm are more intease they when I was younger.  I will never let a doctor touch my prostate  I came in with it and it will be going out with me.  I will fight to the end.  I will never give it up no matter what happens Have a good day  Ken

Hi, I am in Staten Island and considering GL with Dr Vance Moss.  In your experience did you find him to be a good doctor?

 

Michael  why are you having a GL  is that the only thing your being offered.  Do many side effect.  A less evaseive procedure may help  Ken 

I haven't decided, yet.  I am told this or Finasteride which works in some.  MY size is large 120g.

Dr. Moss was my doctor for the last 6 years. I have mixed emotions about him. I also had a very large prostate (over 120g.) From Vance i got a TUMT in 2011, a GL in 2012, a second GL in 2013 due to hemorraging of the prostate and bladder stones (neede 8 pints of whole blood), and a TURP (because he couldn't get a GL machine in hospital) in 2015, also due to hemorraging of the prostate (needed 6 pints of whole blood). At one point I had excessive urination at night (up to 3 liters) for about 9 months. He said he couldn't help me with that. Actually no doctor could and it went away on it's own. Before my TURP in 2015 my prostate was up to 313G. It was 195G. afterward. The TURP preserves tissue and the pathologist found no cancer. I will say that both GL's were less than successful, and the TURP finally gave me a decent stream, and was a faster recovery (about 6 weeks instead of 8 for the GL's). Having had both I think the TURP is superior and wouldn't recommend the GL at all. In  Nov. 2015, 6 months after the GL I started taking dutasteride to keep my prostate from growing back as fast. A year later after taking dutasteride for a year I got a sonogram and my prostate was up from 195g. to 235g. Dr. Moss said he would call me to discuss the sonogram. We made a half dozen calls to his office over the next three months and despite being told he was notified of my call and had the sonogram on his desk, he never called back.

Michael  there are other procedure you can have that will work besides cutting it out  Rezum PAE and Urolift  That is the one I had.  You need to research more and not give in to the doctors.  9 out of 10 cause retro and other problems.  Are they even sure it's your prostate not your bladder. doctor allway want to blame the prostate if they can't find a problem  Once you have it cut out you can't get it back  Ken

P.S., I also forgot to mention I had a membrane partially blocking the prostatic urethra six months after my first GL, and self cathed every 2 to 4 weeks throughout 2013 "to keep the channel open". At the end of 2013 I hemorrhaged and got my second GL. Following both GL's my stream was never right. It stopped the retention, but my stream was still off. I had to lean sideways to keep a stream going. The TURP gave me a proper stream. Also ought to mention that none of the procedures stopped me from needing to urinate 3 to 4 times a night. It may be my bladder was thickened after 20 years of bph and my bladder capacity is low, so after 200ml to 350 ml. in my bladder I wake up. For the past several years I have used a couple of 1 liter urinals in a basket by my bed so I can sit on the edge of my bed, urinate into the urinal in the dark, and get right back to sleep. My PVR (post void residual) has been very good since the TURP (32ml. last measured by sonogram), whereas it was 400ml. before my first GL and from 125ml to 200ml. the year and a half after my first GL. (Since I was cathng every 2 to 4 weeks to keep the stricture from returning after Dr. Moss removed it with a cystoscope tool, I was able to measure my PVR whenever I cathed. I would say a procedure is required to stop retention and keep the PVR low so you are not urinating every 20 minutes because your bladder never empties. I also would say learning to self cath was a priority for me after my first trip to the ER when I was in retention and holding 1400ml. in my bladder.

Noticed a typo, In June 2015 I had a TURP, not a GL. The GL's were in May 2012 and in Dec., 2013.

Unfortunately no procedure (other tha removing it) stops the prostae from growing back, that is the problem. The REZUM (vaporizing the channel with steam sounds similar to my TUMT (charring the prostatic urethra channel with microwaves) which was totally unsuccessful. I don't believe the urolift is offered for prostates in the 120G. + range. The PAE can be used for all size prostates and gets a lot of good reviews. I believe it is offered at Hackensack University hospital. I may consider it if I need another procedure in the future as my prostate continues to grow. Every procedure attempts to reduce the volume of the prostae by some method and/or increase the size of the prostatic urethra opening. They all generally work better on small prostates. Sometimes it is also necessar to trim back the bladder mouth as it may be causing the reduced stream. Sometimes there are bladder issues. A scan generally sorts all that out. Regarding retro, it bothers some but not others. It doesn't bother me at all.

Thank you both for your responses.  The trouble with research is I can find horror stories for every procedure.  I will probably see how the finasteride goes first before doing anything else.  

First of all after the first surgery I would have gotten another doctor no man should have to put his body through that mess.  I am glad retro does not bother you but there are alot of men that it does some even give up on sex because it is not the same that is no way to live.  I will never give in to that type of surgery.  At 61  I'm going to keep my ejaculation till I die.  To me and many other men it goes with the orgasm and for me they are still very intense.  Had dry orgasm  there not for me.  Been through retention and bladder spasm.  Not a fan of catheters.  I have a friend that had cancer and was talked in having his prostate removed.  He said that was the worst thing he could have done.  even his wife agreed with the doctor.  He was only 49.  Now he's 51  divorced and alone because he could not have sex  it mess his life up  He could not give his wife what she needed and the feeling he was use to    He could have sex after he gave himself a shot.  Erection last about a hour but not long enough for a orgasm.  He told me that he can have one but it takes almost 2 hours and he said they are not with the time. He was depressed all the time and all he want to do is die.  I talk with him during the week I tell him that he has to live if not for himeself but for his 2 kids  there 10 and 8.    Whats done is done but you have to go on.  Even man is different and can deal with things in different ways  Surgery is not the answer for all men.  When you pick a surgery you have to be aware of every thing that the surgery will do good or bad.  Take care  Ken

Michael  Yes there are good and bad in all procedure.  Try the finasteride for a while or ask your doctor for something without side effects  there are many that will help.   If you need anything looked up let me know I can print it for you and send it your way.  It's a shame when we get older things change   I just got a email from prostate net on a new pill  I'm going to try it  Its suppose to make it get smaller and help you with all prostate problems  I cant put it on here they will not let me  I will let you know how it is  $12.95  I am going to try it on myself  Take care  ken

Hi Ken, I'm 70 and my orgasms feel as good as when I was a teenager. The dry orgasm is actually a wet orgasm that is directed into the bladder. All the sensations are the same, it's just the semen gets sent in another direction.

I feel for your friend. Has he tried oral sex? A lot of older people do that and it's not necessary for the man to get an erection to receive or give an orgasm.

There's always risks with surgery. I bought into the hype for the first GL, but the second one and the turp where dne in an emergency setting to keep me from bleeding to death so I didn't relly have a choice. Your friend probably was told removing his prostate would save his life, so again, there's not much choice.

Bob and Ken,

I don't think the issue is whether or not a dry ogasm is as good (or not as good) as a "wet" orgasm. It's about informed consent, honesty and decency.

At a minimum, a doctor should fully inform a patient exactly what they probably will experience as a result of an operation or procedure.

If there is any hesitancy at all, a dry run (no pun intended ) with a retro inducing drug like Tamsulosin (Flomax) should be offered the patient. In fact, it should really be insisted upon.  In addition, the patient should be made aware of alternative therapies, be it another type of surgery or procedure, drugs or self cathing (CIC).

Unfortunately, we read too often here, none of this is done.  

Either retro is not discussed at all, or it's discussed in a very misleading manner such as "sex will the exactly the same and you will still have orgasms". While technically accurate, very misleading. 

Jim

Don't no what they told him at the time but he is not happy now and a 50 you should be having fun.  Yes I know you still have the ejaculation and it goes into the bladder.  Mine were not good.  I was on flomax and rapaflo when I first had one the built up was there but when the orgasm hit it went flat.  no feeling at all no after glow.  you know  I did not like them  told my doctor and went off them pill that is when I had the urolift done.  I had bleeding to a year after could not stop then went into spasm and retention.  Had to have emergency surgery.  I would not sign the papers under the doctor ( not mine ) sign a paper that my prostate was not to be touched no cutting.  It took him 30 minutes to sign  I told him that I would bleed to death before I would let him touch me without him signing.  All is great now.  We all have a choise but I feel that they could have stopped the bleeding without cutting your prostate out  He was the one that mess it up in the first place.  We all have to deal with alot when we get older.  We all have to pick how we want to live.  You have and so did I  Take care  Ken  Don't know if they dryed oral  I know you can have a orgasm without a erection 

That is very ture Jim  There have been alot of men on here that the doctor tells them the same thing and when retro happys the doctor laughs about it  I don't think it is funny.  Doctors feel when we get order that it is not a sexaul function we don't need it because we are not having kids.  To me that is wrong it like we are animal were done producing so castrate them   We need to know what is going on we need the information to have the best life we can.  Jim I have said the same thing that you just said  If you are going to have a surgery that is going to cause retro you need to know how it feel and if you can live without it.  The doctor needs to give you a pill to cause it.   Because once they cut the prostate THAT FUNCTION WILL NEVER COME BACK.   Thank you Jim  Ken  

Jim  That is very true.  Doctors do not feel that the ejaclation is a sexaul function, that is why they tell you you will still have a orgasm.  They feel you don't need it because were not having kids.  It's like were animal  once were done castrate them.  Then need to feel what it is like so the doctor needs to put them on a pill before the surgery to see if they can deal with it  I have said that before and so have you.  I feel men give up there prostate to easy.  We need to fight for them  Ken  Thank you JIM  

Sorry Jim  Having a problem with my lab top did not know the first one went through.  You all way say it better then I  Ken  In GA for Father's Day

Late to this comment... but I agree totally... ejaculate significantly increases the pleasure of an orgasm... the dang Urologists seem to not realize this... I had a "partial TURP" in my early 30's and had some retrograde ejac... some, but much less volume, so I know!

I guess it depends on the person. I had an orgasm 6 weeks after my turp and didn't even realize there was no ejaculate. I was really worried about it and it turned out not to matter to me at all. It's been over three years with retro and I never felt my orgasms were in any way diminished. I'm in my early 70's.

It does not happen to all men.  Before I had my Urolift done.  I was on Flomax & Rapaflo.  There was the built up to the orgasms but when it hit.  It went flat no feeling at all.  Like I did nothing.  I would never have a procedure that would take that away for me.  I feel that my ejaculation goes with my orgasm.  Have a great day all  Ken