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Medical Forum / Diseases and Disorders / Prostate BPH / October 2003Retrograde Ejaculation
Just finished talking to the Uro who does HoLEP. He says that any surgery that removes a lot of BPH tissue will/can cause retro, including PVP. It sounded like the only reason that PVP may not cause retro is because it takes away less tissue. Since HoLEP takes away about 90% of the BPH tissue, it has a higher chance for retro. Comments? Dan Dan > Just finished talking to the Uro who does HoLEP. He says that any > surgery that removes a lot of BPH tissue will/can cause retro, [quoted text clipped - 7 lines] > > Dan *************************************** Dan, The general consensus in this discussion group is the PVP has the best chance of not causing retrograde This is just my uneducated personal opinion, but I think it is a whole lot the luck of the draw. Most everyone says the Turp will atomatically inflict retro on a person, but it didn't me. And I know another guy who had the Turp and he didn't come out with retro either. Most everyone in this group had the PVP. See if you can get the percentage of the guys who have had PVP's and have retro and the the percentage of the guys who had the PVP and didn't wind up with reto. It should be interesting. Hank > He says that any > surgery that removes a lot of BPH tissue will/can cause retro, > including PVP. As I understand it, because PVP uses a laser that cauterizes tissue rather than cutting it, there is less blood and debris to obscure the picture on the monitor of what the surgery is actually doing. The green light of the laser cauterizes blood vessels so any bleeding can be stopped as the surgery proceeds. So the surgeon can see exactly what he is doing every step of the way. The Laserscope video (I think it is on their site) shows this very well. The laser is a very precise instrument so the surgeon has greater control. In the alternative procedures, there is more blood and debris to cloud the picture and the instrument used is less precise. So there is a greater danger of damaging the vulnerable bladder neck region which needs to be preserved if there is to be no retro. As I understand it, the sphincter in this regior prevents ejaculant going into the bladder during normal sex. If it is damaged, the ejaculant takes the route of least resistance, i.e. into the bladder. But the bottom line is the skill of the surgeon, what part of the prostate needs to be removed, and how much. BTW, Laserscope claim that any surgeon who has experience of using similar procedures should find PVP easy to adjust to as the skills required are much the same. Disclaimer: I am not a surgeon and this may be incorrect!<G> Derry I'll give you credit Derry. You have done your homework on this stuff. I remember the discussion I had with my doctor. He said "you know about retrograde ejaculation"? I said "yes". He said "ok, I'll schedule the surgery". Was I thorough or what? Hank ************************************ > > He says that any > > surgery that removes a lot of BPH tissue will/can cause retro, [quoted text clipped - 28 lines] > > Derry > I'll give you credit Derry. You have done your > homework on this stuff. I remember the discussion [quoted text clipped - 45 lines] >> >> Derry Hank, Thanks to our National Health Service here in the Uk I have had plenty of time to do the research! Over four years since they wanted to TURP me -- but I refused because of the time required off work. (Thank goodness!). If you email Laserscope (address on www.laserscope.com), they will send you an information pack and the training CD. You might mention that you want to pass it on to your uro -- that will speed them up!<G> A bit like shutting the stable door, etc. but you might find it interesting. BTW, Patrick is the man who really knows his stuff on this group. Do a search on his posts. He had PVP a while back and still gives his time to the group -- for which we are eternally grateful. Patrick is in the laser business (no connection to Laserscope) so knows what he is talking about. Derry > > He says that any > > surgery that removes a lot of BPH tissue will/can cause retro, [quoted text clipped - 28 lines] > > Derry Soon you will know how it has effected you, good luck with your procedure. Derek. On 9/28/03 12:47 AM, in article Xns940445509DE52derryadviegundogscou@130.133.1.4, "Derry Argue" <derry@adviegundogs.co.uk> wrote: >> He says that any >> surgery that removes a lot of BPH tissue will/can cause retro, [quoted text clipped - 24 lines] > procedures should find PVP easy to adjust to as the skills required are > much the same. All I can say is that the PVP is MUCH easier to do than a Ho Laser prostate resection. If you can do a good TURP you should be able to do a PVP with out much problem. I do not think the same is as true with the Ho laser resection. IMO doing the Ho Laser resection takes a lot more work to do well. This is even more so on a big (>60gm) gland. If you do a lot of them if can be a very nice procedure and I have seen people have great results with it. ME |
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