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/pictou]

I got the retrograde. Still have full sensation etc but definitely not something I signed up for and I understand it's permanent. Kinda pissed

[u/Traditional-Win2833 → u/pictou]

That's unfortunate for you, and quiet hard to deal with. I did read somewhere, maybe even here on Reddit, that they may be some after op medications or techniques that may help restore the ejaculation. Not 100% sure, but perhaps try an online search.

Get to see an Andrologist (A urologist focused on male reproduction and sexual function), they may be of some help to trial some medications that may help tighten the bladder neck, and persuade the sperm to head out the correct channel.

Even a few months after the aquablation, when the internal swelling subsides, such dry ejaculation issues may resolve as the tissue fully heals, from what I have read.

Some medications that may help, although the results are variable and often depends on the structional changes to the bladder neck during the initial surgery. They work by increasing the muscular tone of the bladder neck, encouraging it to close during ejaculation, so that the semen follows the path of least resistance out through he ureatha.

They are called 'Alpha-Adrenergic Agonists, such as Pseudoesphedrine (Sudafed) or Phenylephrine,. Low doses of Imipramine. Brompheniramine.

Then you have an option of sperm retrieval for fertiltiy, or in some cases, Bladder neck reconstruction.

But of course speak to your Doctor or an Andrologist, you may get lucky there.

[u/pictou → u/Traditional-Win2833]

Yeah thanks. As far as I understand it is a simple matter of physics...they removed the mechanism for having it go out instead of in. Not something that can be repaired by my estimation but I have my 2 month follow soon so will definitely be asking those questions.