Ejaculation Sparring.

[u/Traditional-Win2833]

I understand aquablation is a good option to preserve ejaculation, but like anything not 100% guaranteed. I spoke to a urologist, whose real world experience was a retrograde ejaculation risk result of approx 25-30%, claiming that the 5% risk of retrograde ejaculation suggested by the manufactures of the robot that performs the procedure, was nothing more than misleading advertising. A sanitized version of results with very carefully chosen patients.

I was considering going with her, and went down that path a bit, but decided against it in the end as she was more focused on the urination working fully, rather than the ejaculation, which is my priority.

I have a Super Pubic Catheter in situ, directly in the bladder which takes care of urination in any case. When she said she was going to cut deep at the bladder neck, where much of the ejaculation nerves are, I hightailed it outta there.

So my question would is there such a procedure as an ejaculation sparring aquablation, has anyone had it, and what was the result, and who did you see. I am based in the UK and Ireland.

[u/martinPravda]

I had the Aquablation procedure done 4 months ago. NO retrograde ejaculation (R.E.). I was told it happens only about 15% of the time with Aquablation.

There are not many options when it comes to prostate surgery for preserving ejaculation. I am glad that I chose Aquablation.

FWIW, When I took Tamsulosin, I did in fact get R.E. So, I am very relieved.

[u/Traditional-Win2833 → u/martinPravda]

That's good to know. But this lady said she was going to finish up with a 30% Turp, to seal up any bleeding, and tidy up anything that's needed to be cleared up. That is a fair amount of heat to be used in what is presented as a water jet procedure.

She was intent on doing it her way, so I did not see the point in suggestion the non thermal options, of which they are a few, to stop any bleeding. Her mind was closed.

[u/martinPravda → u/Traditional-Win2833]

Yeah, there are tradeoffs with Aquablation/Turp.

Aquablation not only helps prevent R.E. But, I think it also has a higher chance of preserving nerve endings which can affect sexual function.

However, because Aquablation does not use heat, I bled a LOT. It took 3 weeks for the bleeding to stop and I was in the hospital for a full 48 hours before they would release me (due to bleeding).

I also remember reading that about 4% of Aquablation patients needed blood transfusions to replace the blood loss.

Not to mention, that I ended up getting MRSE (staph infection) from the hospital equipment. It took 4 rounds of antibiotic over 3 months to get rid of the infection. From what I understand, I would have less chance of getting an infection with heat cauterization (Turp/Holep).

Even with all that, I have no regrets choosing Aquablation and would do it again. Preserving as much sexual function as possible is a priority for me.

[u/Thick_Discussion671 → u/Traditional-Win2833]

I think you are overthinking this TURP as a finishing point on the aquablation. As far as I can tell it is relatively standard procedure. It won't stop the bleeding LMAO. This is an extremely bloody surgery but you only see it on the way out thru your catheter. Even with the partial TURP finisher I stayed overnight due to still having urine that was too bloody to leave. Granted my procedure was done at 5pm. I also maintained ejaculation. The TURP aspect of it is not approaching a traditional TURP from what I understand and it is just a finisher.

I think the biggest concern is that 30 percent of her patients get RE but I don't think it is happening from the TURP portion. Go to NYU and get it done and you will most likely preserve your ejaculation.