Enlarged prostate stops me ejaculating

[Gresley]

I am 78 years old and 3/4 years ago I was diagnosed as having BPH. I take a drug that helps to relieve some of symptoms - frequent and urgent need to urinate, dribbling after urination etc. However it also affects my sex life. When I masturbate I can get erect and reach orgasm, but I don't ejaculates. A small amount off semen leaks out under gravity afterwards. Is there any way of improving this situation?

On the urination side I use urinary sheaths or a bodyworn urinal. This improves my quality of life; I can have a pee anywhere - in the supermarket, on a walk, in the garden.

[Gresley]

Pleased to be able to share these issues

[Karl1942]

Hi Gresley - You have a similar situation to me. I am 77 and been on Tamsulosin for 4 years and Finasteride for 7 months. My prostate is not that big (42gm) but it indents my bladder. Urodynamics and Cystoscopy confirm that I have 'bladder outfall obstruction'. I have only experienced 3 retrograde ejaculations (with these drugs) and although they do no harm I do not like the lack of that final sensation of ejaculation. I restrict myself to one orgasm a week and do not take the pills for 24 hours before attempting. This allows the semen to build up, the drugs to wear off a bit and then produce a proper ejaculation. I also practice edging for 30/40 minutes before allowing the orgasm. In between these weekly sessions I also masturbate but stop before reaching the edge of no return - if I do not stop retro will occur. I am a candidate for surgery but at my age, I will only consent to any procedure if I am desperate. No procedure can guarantee nil after-effects and you are better off with your condom catheter - I am thinking of trying them (currently I use Depend Active Fit underwear).

[Gresley]

Thanks for that Karl, I'll give that a try. To find out a little bit more on what it's like to wear a condom catheter see my video at Vimeo.com/339110885

[Gresley]

I'll ask my GP if this treatments is available in the Uk

[Karl1942]

Hi Nowhard - I have researched all procedures and they all have bad points. The only procedure available to me is TURP which I am not having. All other procedures are out of my financial scope. I have had good results with supplements - night time visits 5-6 down to 2-3. PSA 4.0 down to 2.5. Retention down from 140mls to 80mls. Daily void volumes up from 100mls to 150mls average. Night time percentage of 24 hour day 55% down to 23%. I have read your links in detail and I suggest you read them in detail especially the bad points.

[Karl1942]

I am glad you agree with me that all procedures have bad points and TURP is horrible - that is why I am not having it. Any procedure that involves attacking the prostate whether it be by knife, laser, steam, radio wave, plastic beads (PAE) etc. affects the prostate function and for every lucky man who has no after-affects there are three who do experience bad after- affects. TUNA is not available for me.

[Karl1942]

Hi Gresley - NICE and British Urological Association do not recommend TUNA. You have to go to Europe or USA. My Urologist does not recommend it even if you can afford to go private - the NHS will not back you if you have problems. Studies have found that 30% of TUNA patients end up with retrograde ejaculation and more will require further treatment after 3 years.

[theamos in reply to Karl1942]

I don’t know what your prostate size is but there is a lesser know procedure called suprapubic prostate surgery

With all procedures you are going to have retrograde or loss of ejaculation