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What is the treatment for retrograde ejaculation?

Jul 2016
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Practicing since : 1971
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Hello, 9 years ago at age 45 I had a TUIP procedure (not Green light) because of a narrow passage of my Urethra thru the prostate. The symptoms were identical to BPH, though my prostate was not enlarged. After the procedure everything has been perfectly fine. No more urge, frequency or straining, my flow was very strong. Within the last year, some of the BPH symptoms (lower flor and not fully emptying) have returned, only they are very mild. However, I am now experiencing retrograde ejaculation. My original physician thought that it was odd that I didn't have retrograde right after the initial surgery. I explained that I had no retrograde until now. He has performed thousands of "Green-light" procedures since my surgery. I was looking for another opinion so I had another Uro scope me. He noticed narrowing again at the bladder neck and a "flap" of tissue near the bladder and part of my prostate seems to be pushing into the bladder making a ridge in the bladder. He stated that I could decide on surgery when I felt that the BPH symptoms were a problem. He does not use the Green light, but rather the button because of more control and less scarring. He said that the retrograde could remain. I am familiar with the various laser surgeries, I was a Uro health medical sales rep. He doesn't care about the retrograde, but I do. I am also familiar with the Evolve (Bioletic) laser. Similar to the Button, but seems to be more precise and less bleeds. Should I search for a Uro with "better technique", that could maybe use the most appropriate procedure to reduce the bladder neck damage and possibly reduce the retrograde? Is there info on this?? Your help is appreciated.
Posted Fri, 14 Feb 2014 in Urinary and Bladder Problems
Answered by Dr. P. T. Patil 2 hours later
Brief Answer: Retrograde Ejacualtion is common . Detailed Answer: Hello Thanks for your query,based on the facts that you have posted it appears that you have undergone Tans Urethral Incision of Prostate (TUIP) 9 years ago for what is called as Bladder Beck Obstruction and surprisingly you did not have retrograde ejaculation after surgery which is common and known complication of this procedure. Now you have obstructive urinary symptoms due to enlarged prostate and Urologist has advised Trans Urethral Resection of prostate using laser energy. During any endoscopic resection of prostate no matter what energy source is used bladder neck has to be incised so that it remains open wide enough to have free flow of urine through prostatic urethra . In normal individual during process of ejaculation bladder neck gets closed that prevents semen from entering into bladder but during any endoscopic surgery for prostate As bladder neck is incised, it remains wide open resulting in to entering the semen backwards in to bladder what is called as Retrograde Ejaculation. There are many options of laser surgery commonest being Holmium ,N.D Yag and Thulium laser as a energy source The latest one is Thulium 120 laser surgery .You can discuss the merits and demerits of these techniques with urologist but retrograde ejaculation can not be prevented with any of these energy sources. Hope I have answered your query ,please feel free to ask if you have more questions ,I shall be happy to help you Thanks and Regards. Dr.Patil.
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