11 years since my first post on Self-Catherization (CIC). Now looking at a Prostate Procedure

Men's health
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Hello again, and hopefully some here remember me from back before the forum reboot here. I hope this finds you well.

This was one of my posts on self-catherization (CIC) back in 2015

Since then, I have continued successfully with CIC to the point where I can naturally void whenever I want, but use CIC to keep residuals down and maintain bladder tone. I therefore proved my urologist wrong when he said I would never be able to void naturally again after I arrived in his office with near urinary retention and close to 2 liters in my bladder.

So why am I looking at prostate reduction surgery? The short version is that I recently had a bladder cancer scare that turned out to be a false alarm. But as part of the process, they did a TURBT procedure and found that while my bladder looked OK, my bladder diverticulum was very inflamed, so much so that they originally thought cancer.

Because of this, I will see a urologist soon – first time in ten years – and discuss different options. As before, one of my main criteria is to remain with antegrade ejaculation. So looking at PAE and Aquablation. Welcome any input from those who have had either of those procedures, or anything else that preserved antegrade ejaculation. Also interested if anyone else has a large bladder diverticulum and how that has affected their situation.

For those not familiar, a bladder diverticulum is like a pouch that connects to the bladder and therefore fills with urine. But unlike the bladder, it does not have muscles in the walls that help expel the urine, plus in most cases you cannot get a catheter into it. For that reason, even though I was able to empty my bladder with CIC, the diverticulum often contained urine, which led to UTI’s and finally to the inflammation that looked like cancer on imaging.

Jim

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Hi, Jim! It’s great to hear from you. You helped me a lot when I first had problems with retention and decided to self-cath while researching options. My local urologist at the time only offered TURP, and it didn’t take much research into TURP to tell me that I didn’t want that. However, I want to emphasize that this is purely a decision that only the person himself can/should make.

I self cathed for about 9 months, and decided on Rezum as my best option. I had a good experience with Rezum, and in fact, just had a second Rezum procedure about 5 weeks ago. So the first Rezum lasted about 8 years. Again, I had a good experience, and was able to stop CIC completely between 3 and 4 weeks.

I know that your situation right now, and the situations of those reading this, are unique, and that, while my experience with Rezum was overwhelmingly positive, it may or may not be right for the person reading this. Although I recently posted on here about my second Rezum procedure, I’d like to repeat my recommendations for anyone considering it as a treatment for BPH: 1. Choose a provider with as much experience as possible. Ask him/her how many procedures they’ve done, etc. When my new urologist mentioned on his own that he would avoid the ejaculatory ducts, I felt that I had made a good choice. 2. Insist on twilight anesthesia, as it makes the procedure itself painless 3. Learn to CIC (self catheterize) ahead of the procedure so that you can avoid the dreaded (IMO) Foley catheter. Yes it was a bit painful inserting the catheter after the procedure for the first 2 or 3 times afterwards, but certainly tolerable.

Again, Jim, I wish you the best with your search for a solution.

Regarding the UTI situation, I took D-Mannose daily during the entire time that I was CIC-ing, and never had a single UTI during that time. Of course your situation may be different, but it’s worth mentioning.

All sexual side effects have been nil, and I still have normal antegrade ejaculation (although the volume is understandably less, considering the smaller prostate).

Best regards, Ken

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Hi Ken,

Great to hear from you!

So glad Rezum has worked out so well.

At nearly 80, I’m trying to figure out whether to leave everything alone or try one of the newer procedures. My prostate is big for Rezum, so I’m thinking PAE or Aquablation.

If it weren’t for the diverticulum situation, I probably wouldn’t even think about doing something.

Too bad what happened to this place. I know they lost a lot of people when they closed the forums down. Wonder where everyone went? We used to have some good discussions and debates. Remember the FLA crowd? Last I read the procedure did not seem that durable.

Jim

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Hi Jim,

Yes, I agree; this forum was very helpful to me, and I’m sure to many others. Once I figured out that they had just assigned a system-generated name to the people who had posted, I was able to identify my assigned name and changed it to something close to my original name.

Your situation is different than mine was earlier this year by several points, age, prostate size, and the complication of the diverticulum. I had to research that term, and now I think I understand that the diverticulum itself doesn’t particularly need to be surgically repaired, but the urethra just needs to opened up to allow less restricted flow. If that’s the case, then I understand the reason for considering the aquablation. I did some research a few months ago on the PAE and decided against it. It does sound intriguing but I’ve read too many comments about it taking a long time to make a noticeable difference. For that matter, Rezum also takes some time for the process to be effective. I know that in the past there was a size limit of 80ml, but I understand that they have successfully treated larger prostates with Rezum.

I know that my recent Rezum procedure has a limited life, so I’ll probably be looking at another procedure by the time I reach 80. Right now I don’t know what procedure I’ll choose (assuming that nothing new is available by then). I hope that you have a very successful procedure soon, and that you’ll let me/us know so that I can file it away in my limited memory!

Regards,

Ken

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Hi Jim,

Yes, I agree; this forum was very helpful to me, and I’m sure to many others. Once I figured out that they had just assigned a system-generated name to the people who had posted, I was able to identify my assigned name and changed it to something close to my original name.

Your situation is different than mine was earlier this year by several points: age, prostate size, and the complication of the diverticulum. I had to research that term, and now I think I understand that the diverticulum itself doesn’t particularly need to be surgically repaired, but the urethra just needs to opened up to allow less restricted flow. If that’s the case, then I understand the reason for considering the aquablation. Regarding the PAE, I did some research a few months ago on the PAE procedure as a possible alternative to Rezum and decided that it sounded like a relatively slow process that might or might not work.

I understand that Rezum wasn’t recommended for prostates larger than 80cc previously, but now it seems to be approved for larger ones.

I know that I’ll likely need another procedure in a few years, so I hope that you have a successful procedure, and that you’ll let me/us know about it. I certainly wish you the best of luck.

Regards,

Ken