I I had the rezum procedure performed on me about a year ago and it's been a true mixed blessing . On one hand I'm as happy as I can be since I can urinate like I was 15 years old again. On the other hand I've not ejaculated since the procedure not even a drop. I want to make clear that the procedure did not affect my ability to get an erection at all. However, not being able to ejaculate results in a ruined orgasm everytime I have sex.
I'm 51 years old and my wife and I have sex 2 3 times a week yet I feel sexually frustrated due to the lack of ejaculation.
My urologist recommended I take Sudafed before sex. i tried it once and it didn't work.
My understanding is this problem is far more common then the medical community admits to.
I'm hoping someone may have some good Insight on how to resolve this issue if it's even resolvable .
Does RE result in a ruined orgasm? I thought it just ejaculates to the bladder inward instead of outward but does not change the feeling or sensation? Is that wrong?
Not a doctor but as I understand it, your condition of RE is a permanent results of the procedure. This is because during the Rezum process, the ejaculatory ducts are cut, melted or just destoryed as a results of the procedure. This happens to alot of men and in a lot of cases not explained in the consult prior to the procedure.
It can happen in most BPH procedures. I went with FLA to avoid this and was successful but it can even happen in Focal Laser Ablation with full eyes on the object via the MRI as they are ablating . A lot of the cause can be from the doctor chosen to do the FLA. Sad fact, but some make mistakes even though they can see what they are doing real time. The choice of doctor makes a big difference.
Sorry to hear about your situation but RE is a condition that is easier to deal with than the symptoms of BPH and poor urination.
Dan, Sorry to hear about your problem. Not sure if its resolvable/fixable. Your post will definitely help other guys. I would 100% blame your urologist. I'm sure he downplayed the side effects to you. My urologist did the same thing. When i heard him say that TURP might cause retro but its" no big deal"( no big deal to who? To him!!) , I started to educate myself and eventually went with PAE. Urologist don't do PAE, interventionist radiologist do, so they don't recommend the PAE procedure. Like a lot of other people out there some Dr's are in business just for the money and really dont care much for their patients. I don't trust most of them, i only go to my uro now for a DRE and PSA test once a year, other than that i educate myself. I hope there's a fix for your retro. Maybe there's surgery that can restore proper function. Good luck with it. Tom
Hi Dan
Re goes into bladder .... a la Flomax and Silodyx.
Its a let down ... 20% of pleasure ... but lady still gets the same feeling... and isnt left with the mess!
i had a PAE 18 months ago ... its not 100% and I take Silodyx from time to time ...especially after sex ...which seems to enflame the Pg and restrict flow of urine.
As the one chap said .. better to piss properley and at least keep your lady happy ?
No, RE is not a typical result of Rezum. This is the reason that I elected to go with Rezum two years ago. Ejaculation was back to pre-Rezum levels within two months of the procedure and has been fine since.
However, I imagine that a steam injection in the wrong location could result in RE. It seems that as far as BPH is concerned:
doctors + procedures + the luck of the draw = individual results.
TG, you are correct. It was over 30 months ago and I visited each of the Interventional Radiologist that did both PAE and FLA at that time. Both these prostate procedures are only done by IR and Uros won't tell you about either of these as it is not something they are capable of doing. I also found all of the IRs much more honest and transparent than the Uros about the any procedure, the recovery and the outcome.
They would tell you the percentage chances of the results and what you could expect. I have since found out that the IR community is some of the smartest doctors in medicine as they work on brains, lungs, hearts, kidneys, livers with various ablations and procedures. My Dad had one do his heart ablation for Afib and it was excellent results. There are many less of these IR's specializing in prostates compared to the vast urological field. We are all lucky that some have chosen prostates to specialize in.
Sorry to hear about your problem. I am contemplating REZUM . I did not know that RE is due to damage of ejaculatory duct. I thought it was due to change of anatomy after procedure where ejaculate follows path of least resistance. Maybe the injection was too close to bladder neck.
I'll trade your RE for the RE, ED and UI that resulted from my GL procedure.(That's almost the full Monty of urinary acronyms.)
Didn't ruin it for me, in fact I think orgasms are more intense now, but my wife always say it feels weird that nothing is happening . I think she misses it.
wow, I didn't expect so many replies in a day. thank you you all for your insight .
j12080, you mention this is result of ducts being damaged. it makes sense in theory but I'm not sure if that's the case here. so i wasn't able to urinate at all, not a drop, for the first 5 weeks after the procedure but I could ejaculate. Week 6 I could urinate a little and still ejaculate. by week 7 I could pee like a race horse but i could no longer ejaculate. if ducts were damaged shouldn't they have stopped immediately.
I suspect the bladder neck is open to wide.
i don't know of i could trust another urologist since I believe most doctors are robber barons.
my urinary issues began 11 years ago but I was able to manage it with medication. Two years ago i needed a hip replacement and I woke up from the surgery not able to pee at all. For 4 months I relied on a catheter because I could not urinate. not even a drop.
I went to two urologist . One said I need to continue catheterizing myself because my prostate is only 22 ounces. the other sold me on Rezum.
So I agree that this is a small sacrifice considering I wasn't able to pee at all and now I have zero urinary retention.
Also , my sex drive is actually up a little but only because I can't get satisfaction.
Hi, I had the Rezum procedure done in January. I also have retrograde ejaculation. I am better than I was before the procedure but still have many of the issues I suffered with before. My urologist said it is because we only did 5 injections (to avoid side effects.) He also did recommend sudafed which didnt work for me either. The dry ejaculation has messed with my head, Im 59. The only benefit is that when I stand at the toilet something actually comes out rather then standing there for 5 minutes. My urologist suggested doing it again in the future. Good luck
Dan,
Procedures which commonly result in RE, such as TURP and HoLEP, will do so immediately. In your case, RE didn't materialize until many weeks post-surgery. Ask the doctor who performed your REZUM to explain. Maybe there is something that can be done surgically to correct the problem.
Post-operative urinary retention (POUR) is not unusual following orthopaedic surgery. Your case seemed severe. Was your prostate very enlarged at the time of your hip replacement?
Also, you are probably confused as you say your prostate "is only 22 ounces." If you truly mean 22 ounces that equates to 624 grams, and if prostate density is taken as 1 g/cc (which is the density of water), then your prostate would measure 624 cc - this would be massive and about 30 times normal size. If you meant 22 grams, then your prostate would be the size of that of a healthy man in his 20s - and should not be the cause of severe urinary retention.
I've considered REZUM but have read it is limited to prostates < 100 cc (or, 100 g). I'm a little beyond that. How large was your prostate prior to REZUM?
As others have said, although RE is a disappointment, you appear to be relieved of LUTS, and now can pee like a teenager. I hope that is no small consolation if RE is permanent, and you can take solace in knowing you have recovered quality of life that BPH was taking from you.
Michael
i have re from fla. Had fla twice first time no re second time re. its kinda a bummer, but i can pee. unfortunately most of my problem now is my bladder. i have to take 4mg flomax which does effect my libido. but over all picture is much better than before fla.
let us know if its fixable.
jim
lol, Michael you are correct. it was 22 grams but that measurement was taken 4 years prior to the Rezum. my understanding is 10 to 16 grams is normal. in 4 years it may have increased..
So to summarize what I've learned is retro ejaculation is fairly but this procedure and it appears to be permanent. Also no one's had a procedure t
hat can correct this problem.
Hopefully , if somebody will soon have a solution
I'm considering having Rezum also along with PAE and button turp. Had 5 urolift clips placed 3 years ago that no longer do the trick.
When my main uro initially discussed GLL with me (that's what his group does + UL) and we got into the topic of RE, that escalated all of this to a much higher priority for me to find the right combo of procedure and surgeon. My main uro actually said to me "if you aren't going to have children or star in adult movies it shouldn't matter." I thought that was particularly inconsiderate, but he and I have had a very good working relationship. Eventually I got him to refer me to a uro in Charlotte NC who does Rezum whom I've consulted with but am not ready to pull the trigger.
That said, from what 2 different uros have told me about what causes RE and what I learned from reading some studies in professional journals, RE in the context of BPH can be cause by any of 3 physiological issues:
(1) surgical procedure causes damage to nerves and/or muscles that are involved in slamming the internal sphincter shut that is in the bladder neck. I was told that sphincter slamming shut is the last thing that happens in the male sexual process prior to ejaculation.
(2) the ejaculatory ducts or seminal vesicles are damaged. My sense is this is relatively rare at least in cases where the surgeon is trying to preserve ejaculation. They use the verumontalum which is where the ducts are located as a landmark so they don't risk injuring the outer sphincter because that would cause incontinence for sure.
(3) With TURP and related procedures most surgeons remove a lot of tissue and try to bore-out the transition zone of the prostate so that there is a void significantly larger than in a healthy prostate. If this void in the prostate is large enough the muscular contractions that force ejaculate out can't squeeze down enough to force it out, even if the inner sphincter is functional. In other words, the semen just sits there in a big void.
Please bear in mind I am not a medical professional, this is just a rough summary of what I've been told by a couple of uros I've seen and asked about RE. Unfortunately this condition we have has no "cure=all" remedy.
Russ,
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I had a Rezum done at the end of November 2018 as it was the least invasive procedure with the least complications of the options that I considered. My 2nd choice was GLEP. I would never do a TURP. When doing the Rezum, the urologist avoided the verumontanum, sphincter complex. I do not have RE. The Rezum cleared the blockage, but due to bladder damage, my PVR's are over 100 ml.
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Steve
Russ 777.
you list three reasons why one would not ejaculate after a prostate procedure .
I just want to clarify one point you made . reason number three if I'm reading it correctly applies only to a turp not to resume ?
Dan, good point. It is possible if Rezum or any procedure causes enough tissue to be removed or necrotized then it stands to reason that you could get RE from too large of a "chamber."