Holep sugery and retrograde ejaculation: Do you have it and what is it like?

[wpcoe]

On 8/22/2023 at 7:33 AM, CharlieKo said:

Before you do anything. Research stinging nettle capsules. Available on Lazada. I took these and it reduced the size of my prostrate. A more holistic treatment than the drugs the doctor prescribes.

What "dose" of stinging nettle did you take?  On Amazon I see capsules of varying quantities like 250mg, 500mg, 750mg, 870mg, etc.

[natway09]

I hope you have had more tests than just a PEA which can be highly dubious in finding anything

until very late.

Check out the BNH specialists.

[CharlieKo]

21 minutes ago, wpcoe said:

What "dose" of stinging nettle did you take?  On Amazon I see capsules of varying quantities like 250mg, 500mg, 750mg, 870mg, etc.

500mg.

[wpcoe]

8 hours ago, CharlieKo said:

500mg.

Thanks. ????

[superal]

To the OP , Adumbration , I admire your courage in bringing this delicate subject to this forum . Most men over the middle age years will have this problem to some degree . Many men are stubborn in getting a check up on their prostate because of embarrassment of a digital examination . I have been Googling the Aquablation technique and it appears to address all your concerns . Extract below from https://potomacurology.com/services/bph-treatment-options/aquablation/

What Are The Side Effects of Aquablation Therapy?

We know that the primary reason men are delaying surgery is because they are concerned about side effects.¹ In fact, a recent survey shows that 85% of men are concerned that surgery will cause incontinence, and 4 out of 5 men are concerned that surgery will have a permanent impact on their sexual function.¹

In clinical studies, men who had Aquablation therapy had a very low rate of irreversible complications—incontinence, ejaculatory dysfunction, erectile dysfunction.^2,3

0%

impact on erectile function, orgasmic function, sexual desire, intercourse satisfaction or overall sexual satisfaction^2,3,4

NEARLY ALL

men with BPH preserve ejaculatory function with Aquablation therapy^2,3,4

99%

men with BPH did not have incontinence after Aquablation therapy^2,3,4

[GarryP]

28 minutes ago, superal said:

To the OP , Adumbration , I admire your courage in bringing this delicate subject to this forum . Most men over the middle age years will have this problem to some degree . Many men are stubborn in getting a check up on their prostate because of embarrassment of a digital examination . I have been Googling the Aquablation technique and it appears to address all your concerns . Extract below from https://potomacurology.com/services/bph-treatment-options/aquablation/

 

Strange, I have never been digitally examined.

 

I had Rezum treatment at Bamrungrat Hospital in October 2021. But not sure whether it would be suitable for Adumbration as his prostate may be too large. The treatment is for prostates under 80cc. Mine was only 38 or 39. May be worth checking out these threads. While mainly about Rezum, they do mention other available treatments in Thailand.  

 

 

Edited August 24, 2023 by GarryP

[superal]

3 minutes ago, GarryP said:

Strange, I have never been digitally examined.

 

I had Rezum treatment at Bamrungrat Hospital in October 2021. But not sure whether it would be suitable for Adumbration as his prostate may be too large. The treatment is for prostates under 80cc. Mine was oly 38 or 39. May be worth checking out these threads. While mainly about Rezum, they do mention other available treatments in Thailand.  

 

 

How is the size  of a prostate made ? Also I thought that a digital exam was the most reliable indicator of an enlarged prostate and normally the first procedure along with the PSA test .

[GarryP]

23 minutes ago, superal said:

How is the size  of a prostate made ? Also I thought that a digital exam was the most reliable indicator of an enlarged prostate and normally the first procedure along with the PSA test .

My prostate size was measured using MRI. I had a number of other tests, including PSA, uriflow, etc. and was expecting a finger up the bum too, but it never happened. 

[superal]

6 minutes ago, GarryP said:

My prostate size was measured using MRI. I had a number of other tests, including PSA, uriflow, etc. and was expecting a finger up the bum too, but it never happened. 

Tests in Thailand ?

[GarryP]

22 minutes ago, superal said:

Tests in Thailand ?

Yes. Bamrungraj Hospital. 

[Adumbration]

Thanks Garry P and Superal for your input.  If I undergo surgery it will be in either New Dehli or Kolkata.  I will report my experience back here.

 

[Adumbration]

10 minutes ago, GarryP said:

Yes. Bamrungraj Hospital. 

Do you have retrograd ejaculation?  What was the cost for your MRI at BGH?

[Adumbration]

1 hour ago, superal said:

To the OP , Adumbration , I admire your courage in bringing this delicate subject to this forum . Most men over the middle age years will have this problem to some degree . Many men are stubborn in getting a check up on their prostate because of embarrassment of a digital examination . I have been Googling the Aquablation technique and it appears to address all your concerns . Extract below from https://potomacurology.com/services/bph-treatment-options/aquablation/

What Are The Side Effects of Aquablation Therapy?

We know that the primary reason men are delaying surgery is because they are concerned about side effects.¹ In fact, a recent survey shows that 85% of men are concerned that surgery will cause incontinence, and 4 out of 5 men are concerned that surgery will have a permanent impact on their sexual function.¹

In clinical studies, men who had Aquablation therapy had a very low rate of irreversible complications—incontinence, ejaculatory dysfunction, erectile dysfunction.^2,3

0%

impact on erectile function, orgasmic function, sexual desire, intercourse satisfaction or overall sexual satisfaction^2,3,4

NEARLY ALL

men with BPH preserve ejaculatory function with Aquablation therapy^2,3,4

99%

men with BPH did not have incontinence after Aquablation therapy^2,3,4

Nothing courageous about posting on an anonymous forum.  

[scubascuba3]

11 minutes ago, Adumbration said:

Thanks Garry P and Superal for your input.  If I undergo surgery it will be in either New Dehli or Kolkata.  I will report my experience back here.

 

How have you researched Dehli and Kolkata?

[GarryP]

36 minutes ago, Adumbration said:

Do you have retrograd ejaculation?  What was the cost for your MRI at BGH?

No, I do not. Incidence of retrograde ejaculation post treatment is 3.1 % as per a study undertaken in 2022. I can't recall the cost of my MRI. I paid a package price with a few extras, but I got a special price as I managed to get in when they were promoting Rezum as a new treatment.  

Edited August 24, 2023 by GarryP

[KhunBENQ]

On 8/22/2023 at 7:31 PM, Adumbration said:

take 12 mg of doxazosine daily

With Tamsulosine you would have retrograde already. My experience.

 

I had TURP almost 4 weeks weeks ago and retrograde. All bone dry. 66 yr and no plan to plant any brats. So for me just a very minor concern.

Edited August 24, 2023 by KhunBENQ

[talisman01]

19 hours ago, Adumbration said:

Thanks. Where exactly did you have the proceedure, here in Thailand or someplace else.

The procedure was done at Guy's Hospital in London. I'm told that the prostate Aquablation process was first developed is about 5 years ago and has since had a rapid take up in many other countries because of its precision and because it's far less intrusive and, for larger prostates, much safer than TURP. I understand that Bumrungrad Hospital in Bkk now offers the procedure.

[Adumbration]

7 hours ago, talisman01 said:

The procedure was done at Guy's Hospital in London. I'm told that the prostate Aquablation process was first developed is about 5 years ago and has since had a rapid take up in many other countries because of its precision and because it's far less intrusive and, for larger prostates, much safer than TURP. I understand that Bumrungrad Hospital in Bkk now offers the procedure.

Thanks for that information.

[Adumbration]

9 hours ago, KhunBENQ said:

With Tamsulosine you would have retrograde already. My experience.

 

I had TURP almost 4 weeks weeks ago and retrograde. All bone dry. 66 yr and no plan to plant any brats. So for me just a very minor concern.

Thanks for your input.  Can I ask why you decided on Turp rather than other options.  Can I also ask is sex still satisfying, do you still climax.....how do you know you are finished.  I know these a very intrusive questions, but I am genuinely interested.  

 

I chose doxazosin because I also have high BP.  I used to take Losartan (after lots of trial and error, could not take enaprile or any other ACEs because I developed chronic ACE cough).  Now I just take the doxa....it is good because it kills two birds with one stone, lowers my BP and helps me to pee.  So a convenience and cost saving win.

 

I just checked, apparently RE is not a very high risk with doxa also:

 

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 α-blockers, such as doxazosin, terazosin, or alfuzosin, generally were lower than 1.5%.

[Adumbration]

10 hours ago, scubascuba3 said:

How have you researched Dehli and Kolkata?

Only online and through google customer reviews and photographs.  I also have previous knowledge of medical services in KolKata.  I worked as a carer in Mother Teresa's street hospital there nearly one million years ago.

Edited August 24, 2023 by Adumbration

[superal]

19 hours ago, Adumbration said:

Thanks Garry P and Superal for your input.  If I undergo surgery it will be in either New Dehli or Kolkata.  I will report my experience back here.

 

May I ask if you have ever taken Viagra or anything similar . Not just for sexual reasons but also relaxes the prostate and makes urinating much easier . There was an article on the BBC News medical journal a couple of years ago that stated men over 50 years old would benefit from taking 50 mg of sildenafil ( or a generic pill ) a day to control and reduce the prostate size . This may be too late for  you but it may help other readers 

[KhunBENQ]

10 hours ago, Adumbration said:

Can I ask why you decided on Turp rather than other options.  Can I also ask is sex still satisfying, do you still climax.....how do you know you are finished.

For me it was too late for other options. Size 119, PSA 20.

Other options are usually limited to size 80.

I am fortunate enough that no cancer was found.

Can't say too much about sex life yet, not too much in the mood while still fighting with urinary infection, taking antibiotics and still limit activities (no bicycle, no motorbike).
But yes, willy still works somehow and climax is reached (better or worse, too early to tell). So sure you know you are finished.

But of course you and your partner have getting used to the fact that all remains dry.

[GarryP]

2 hours ago, superal said:

May I ask if you have ever taken Viagra or anything similar . Not just for sexual reasons but also relaxes the prostate and makes urinating much easier . There was an article on the BBC News medical journal a couple of years ago that stated men over 50 years old would benefit from taking 50 mg of sildenafil ( or a generic pill ) a day to control and reduce the prostate size . This may be too late for  you but it may help other readers 

Standard daily dose of tadalafil (Cialis) is 5mg for treatment of BPH. It is also the same daily dose for treatment of ED and/or PE. However, Cialis is very expensive in Thailand and prescription only. Despite the patent having expired quite a few years ago, generic tadalafil is not available in Thailand, or it wasn't the last time I checked in about 2020-21. From checking just now, the only Thai companies that have registrations with the Thai FDA for generic tadalafil are Pinnacle Chemmed (tadalafil is not listed in their APIs on their website) and Sai Pharma (which is a supplier to Pinnacle among others). The Cialis brand registrations are owned by Zeullig Pharma in Thailand, as they entered a partnership with Eli Lilly for distribution of this drug, among others, in Asia.  

[Ben Zioner]

12 hours ago, Adumbration said:

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 α-blockers, such as doxazosin, terazosin, or alfuzosin, generally were lower than 1.5%.

Yes,  but the combination of Doxazosin + Finasteride is at least as bad as Tamsulosin.  Many are on this combo of meds.

[Adumbration]

11 hours ago, superal said:

May I ask if you have ever taken Viagra or anything similar . Not just for sexual reasons but also relaxes the prostate and makes urinating much easier . There was an article on the BBC News medical journal a couple of years ago that stated men over 50 years old would benefit from taking 50 mg of sildenafil ( or a generic pill ) a day to control and reduce the prostate size . This may be too late for  you but it may help other readers 

Never needed and never used Viagra or similar.

[Adumbration]

9 hours ago, KhunBENQ said:

For me it was too late for other options. Size 119, PSA 20.

Other options are usually limited to size 80.

I am fortunate enough that no cancer was found.

Can't say too much about sex life yet, not too much in the mood while still fighting with urinary infection, taking antibiotics and still limit activities (no bicycle, no motorbike).
But yes, willy still works somehow and climax is reached (better or worse, too early to tell). So sure you know you are finished.

But of course you and your partner have getting used to the fact that all remains dry.

Thanks for the additional information.  A PSA of 20 must of had you very concerned.  Can I ask you did your PSA results steadily increase over time, or did you just have one normal test and then the next year suddenly you were at 20?

[superal]

On 8/25/2023 at 11:23 AM, GarryP said:

Standard daily dose of tadalafil (Cialis) is 5mg for treatment of BPH. It is also the same daily dose for treatment of ED and/or PE. However, Cialis is very expensive in Thailand and prescription only. Despite the patent having expired quite a few years ago, generic tadalafil is not available in Thailand, or it wasn't the last time I checked in about 2020-21. From checking just now, the only Thai companies that have registrations with the Thai FDA for generic tadalafil are Pinnacle Chemmed (tadalafil is not listed in their APIs on their website) and Sai Pharma (which is a supplier to Pinnacle among others). The Cialis brand registrations are owned by Zeullig Pharma in Thailand, as they entered a partnership with Eli Lilly for distribution of this drug, among others, in Asia.  

Cialis is available in Thailand and a quick Google search came up with several suppliers including the next link https://www.misskamagra.com/cialis.html  . Granted it is not cheap and the pills are 20 mg , not 5 mg . No prescription needed .  I have also seen it for sale in Pattaya , by mobile vendors but maybe a copy because much cheaper than on line pharmacies .

[GarryP]

1 hour ago, superal said:

Cialis is available in Thailand and a quick Google search came up with several suppliers including the next link https://www.misskamagra.com/cialis.html  . Granted it is not cheap and the pills are 20 mg , not 5 mg . No prescription needed .  I have also seen it for sale in Pattaya , by mobile vendors but maybe a copy because much cheaper than on line pharmacies .

Tadafafil (Cialis) is prescription only. Drug stores selling it without prescription are doing so under the table. There are loads of streetside vendors along inner Sukhumvit in Bangkok selling a variety of performance enhancers including Cialis, but they are doing so illegally and there is no guarantee you are buying genuine product. Buyer beware. 

[Lacessit]

I  asked my very experienced urologist in Australia whether I should stay on my finasteride/doxazosin medication, or have a TURP ( Holep ). He responded it was better to stay with the current medication, as the risk of incontinence and retrograde ejaculation after a TURP was quite high. I do not currently have RE. Apparently my chances of getting it after a TURP are about 50%.

 

Subsequent to that, my GP switched me to Doubluts, after I complained I was getting up 4-5 times a night to pee. Doubluts is 500 uG of dutasteride, 400 uG of tamsulosin. It did improve my night excursions to twice mostly.

It is available in Thailand, I was quoted 1800 baht for a month's supply ( 30 tablets ).

 

I would suggest the OP needs to talk to a good urologist.

[Ben Zioner]

On 8/24/2023 at 12:54 PM, Adumbration said:

Thanks Garry P and Superal for your input.  If I undergo surgery it will be in either New Dehli or Kolkata.  I will report my experience back here.

 

Any reason for planning treatment in India. When not available in Thailand  I'd rather go the Singapore as I'd feel safer there. Maybe I am wrong?

 

Anyhow It'd be great if you could keep us posted.