Had PAE (Prostate Artery Embolization) at UCSF in San Francisco a month ago. Spent about 6 hours in the clinic, the procedure itself took about 90 minutes. Lightly sedated, semi-conscious, no pain.

The first 3 days after were rough. I had to pee about every 20 minutes through a burning urethra. It was hard to get the flow started, so I'd stand in the shower or use my bidet to relax the pelvic muscles. I'd eke out a bit of urine, then back to bed. After 3 days the burning stopped, but for another 4 days I still had to pee every 20 minutes. After the first week, I started to feel normal, only had to pee about once an hour.

After the second week my BPH symptoms largely disappeared. I now pee easily with no hesitation, and good flow. Still getting up a couple times a night but that's better than the 3-4 times a night I experienced before. No longer take Tamsulosin. Sexual function is normal. Goodbye BPH!

My Doctors' nurse said I can take a bath but everything I read says not to take a bath with the catheter in. I would like to take a bath and also clean my catheter bag out while doing so.

Please advise.

I wondered how the men and their partners here feel about losing the ability to ejaculate after HoLEP. Do you miss it, prefer it, feel less of a man ? How do your partners feel about your dry orgasms, your being sterile.

Guys with BPH tend to have tight pelvic floor muscles. This is driven by urinary urgency and frequency. The brain interprets these pelvic sensations as a warning signal to the body and the pelvic floor muscles shorten, like a dog tucking its tail. Here is a video showing how the penis and testicles fill with blood and how having tight pelvic floor muscles alters erectile quality:

https://youtube.com/shorts/DV4Vmus\_Cjk?si=vxIhyGMhnqyncubC

so since 5 years I had this on and off weeks. meaning that some weeks I pee less than normal a bit and some weeks too little with both frequest bathroom visits. i don't have burning sensation except when i don't drink water, just difficulty starting to pee with normal pee colour and can't empty my bladder in one go have to go like 10 or 11 times a day if not more. sometimes lower stomach or side or back pain. it maybe inflamation i don't really know. I have been on tamsulin for almost a month now 9 pm everyday. at first there were goood results with terrible firstime side effects but after a week or two reurned to same old same. idk if this is related to masterbation habits or something else. so please some advice. I am 21 by the way.

I have a PAE procedure scheduled in July & am curious. What should I expect? Per the doctor no side effects & typically a significant reduction in size of prostate.

I did a search here & could not find anything.

PAE= prostate artery embolism.

Thanks

Does anyone know if dry orgasms are for life after HoLEP. I had my prostate fully enucleated (hollowed out) leaving behind just the capsule. I have completely lost the ability to ejaculate now, will I ever get it back ?

Anyone have any tips to prepare for that torture ?

I've been waking up 5 or 6 times a night due to prostate issues for years now, and finally hit a point where I need something more than Tamsulosin. I had a checkup with on urologist who recommended TURP after a cystoscopy, but I knew I didn't want to go that route so I got a second opinion. The second urologist did an ultrasound (the uncomfortable kind) and noted that my prostate really isn't big enough to recommend TURP, Holep or Aquablation, but he thinks TUIP would help. Since I'm only at 26cc but still experiencing a stupid level of nocturia, I wondered if anyone here had any experience with TUIP and what the whole process is like.

I am using ezetimibe as a prostate shrinker. Yes, I know it is not recommended for that, yes, I know there are no human trials. I am only in the first month so I don't know if it works yet. I am encouraged that there is no evidence of prostate atrophy, or sexual disfunction. I will report back from time to time to say how it is going. The reason there are no human trials, ( the computer says) is because there are other drugs, such as Dutasteride, made for this. These drugs, however have sexual side effects, so I want to try this.

Anyone experience this? I found out I have BPH, as an incidental finding on a CT to diagnose a bowel problem. They didn't even tell me actually, I requested the CT results.

I thought the flattened stools were a symptom of Inflammation in my rectum or elsewhere in my colon. Now I'm wondering if it could be due to my bulky prostate pushing into my rectum.

Does this sound familiar to anyone here?

How to Keep Your Prostate Healthy—And How to Tell When Something’s Up With It - Men’s Health

This is not meant to be a promotion or advertisement in any way, nor an academic study. Please remove this post if it violates community rules. My goal is to learn more about the patient perspective and how physicians can improve the overall experience for future patients

I’m an IR in training and hoping to eventually build a practice focused on men’s and women’s health including PAE

For those of you who have had a PAE done what are some things your IR doc did that made your experience particularly positive? On the other hand what made the experience frustrating or negative? I’m also curious how most of you initially heard about the procedure. Was it through a urology referral, online research/social media, another patient/friend, other?

I am a 71 year-old who had HOLEP4 months ago on a 260 cc huge prostate. I had suffered from various urinary and prosthetic symptoms for literally decades.

The surgery, which I had in Japan, actually,, was uneventful and painless, and apparently done with great precision. I have gone from massive numbers of clots, for which I was hospitalized twice with bladder blockage, and range of other related problems, to urinating forcefully, and without pain.

However, I did not ejaculate for four or five months prior to the surgery, because of concerns about exacerbating, bleeding related symptoms, and have not ejaculated for four months since the surgery initially to let the prostatic bed heal, and then subsequently because of anxiety about starting to ejaculate again after so long, particularly with the almost certain retrograde ejaculation.

I feel ready to try ejaculation again, and would be immensely grateful for any input from people here about their experience, about what I can expect, about how retro ejaculation is different,, etc.

Thank you so much for any input you can provide. . I am of course happy to answer any questions as well.

a decade of on an off bph symptoms let me hope that it would go away. i am a very young 60+ sportsman with zero problems in my life. therefore i thought that my body would heal it naturally. unfortunately the stream got weaker and weaker and i sometimes i even had to get up at night in order to pee.

what made me do nothing about it were intermittent periods of a stronger stream and normally i could even sleep for 8 hours without getting up.

but suddenly it worsened and i got the usual symptoms like urgency and weak stream whenever i was on an airplane or in a bus. i decided to do something about it. on a trip to south america i was completely blocked and i had to go to the nearest hospital to drain the bladder. the urologist recommended turp which i rejected because it is not permanent and it has many side effects. i asked him about holep but he could not provide it. the urologist recommended to leave the catheter inside for 10 days. i took it out after 2 hours and i could urinate with a weak stream and and i could almost empty the bladder. i started to research all holep operators worldwide. most did not even talk to me. i live in north america and i thought mexican holep operators are qualified and much cheaper. i experienced the opposite: they were hiding their experience and the price they quoted was much higher than anywhere else in the world. i also tried to talk to hospitals in thailand and in turkey. they all wanted to see extensive tests which i did not have at this time and they stopped talking to me when i could not provide that.

therefore i focussed on the usa finding out that there were only a few very experienced holep operators who do successful holep operations every week. i watched all available videos about holep leading to people like amy krambeck and others. i contacted everyone who i watched on youtube and who i found online. hardly anyone talked to me. only dr.austen slade who is one of the most experienced holep operators called me and answered all of my questions. i was impressed. after the call i researched his reviews and i saw that almost all of his operations were very successful and the people were very happy with the results.

i was asked to send the results of a pelvic mri to know the size of the gland as well as blood test, urine tests and an ekg. i did all tests and my gland turned out to be 200g which is extremely large. also the bladder showed to be distended on the mri. all other values were excellent. i was shocked. holep seemed to be the only option for an extremely large gland. i sent my studies to the office of dr.austen slade and agreed to an operation date and a price about one and a half months ahead.

i flew to boise on a monday in april. the next day i had a cystoscopy which was a requirement for the operation in order to investigate the bladder and the urethra. i felt no pain. no strictures were found and the bladder was looking ok with visible blood vessels from straining. after the cystoscopy i could not urinate. only some drops of blood came out. i was kind of blocked again but i hoped it would work again after a few hours and it did in a very weak stream.

the next day i had the holep operation in a surgery center in boise. everyone was very friendly, i was treated like in a spa. i was prepared for about one hour then i was given a spinal anesthesia which did not hurt either. i was given a monitor to watch the whole procedure which i appreciated. dr.austen slade had a student operator watching his procedure (i had to agree to that before the operation). he commented every step of the operation. i watched and listened the whole time. after the peocedure i felt already very well except of my legs being unable to move for more than 40 minutes. i was told that the operation was successful and most of the gland was removed (he mentioned the exact amount but i forgot how much it was)i got some food and some water and i could use my phone and my computer.

i had this nasty thing in my bladder. before the operation i was asked if i preferred to have it removed shortly after the operation or if i want to remove it the next morning myself in the hotel. i told him that would leave this decision up to him because he knew my situation and my anatomy. now i was told that it would be better to leave it in overnight and remove it the next morning. i could hardly sleep and the next morning the large bag was completely filled up with urine and blood.

i took the thing out and could only urinate a few drops. during the day the stream got a little bit better and finally in the evening it came out really strong.

it is now three weeks after holep and i can pee like a firehose from day two after the operation. the stream is much stronger than when i was 20 years old. i had no blood in the urine from day 2 to day 6 and only a little bit of blood coming out intermittently from day 6 to day 11, then it stopped. i bought urine pads at the recommendation of dr.austen slade but i never had to use it. i got zero incontinence, not even a drop. i did sports from day 10 and i started to walk fast and lift weights from day 14 because i am feeling great. at no point did i have any pain or even discomfort. i feel that dr.austen slade gave me my life back.

i am only writing my experience to help people in a similar situation.

Did anyone experience thin watery semen after HoLEP, also did anyone find their ejaculation became a dribble rather than a spurt.

Had Optilume 11 days ago on April 27.
Not much pain from the procedure.
The catheter sucked but was removed on April 29.
No noticeable improvement until May 7.
I noticed fewer runs to the bathroom the last few days.
Last night, May 8, I only got up twice to pee.
My pee stream is still weak and dribbling also.
I feel my bladder emptying a little better.
Less urgency when I need to pee.
No further blood clots noticed.
Still sleeping in Depends as I fear leakage.
Doctor appointment on May 14 for flow test and possibly scope test.
Told best results in 3 months.
I am 71 year old male. I live in Las Vegas.
Only issue was enlarged prostate at 48.1 size.
Any comments or questions?

I have a question for those that have had the Prostetic Artery Embolization procedure. How many weeks after was it before you noticed your semen returned back to it’s whitest yellowish color? I first noticed after 1 week it was bright orange. 2 weeks it was orange red, 3 weeks its more brownish red. Im just trying to figure out if this is normal? My IR doctor didn’t tell me what to expect, but just told me to hold off 1 week post procedure before I had any semen release. Also how many weeks after did you notice your ability to urinate better? Im not having to wake up at night, but i notice that my stream is still weak and still have start and stop with my urine. Im 19 days post procedure. Many thanks!