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15 yrs of thinking I had enlarged prostate...new cystology exam says otherwise...what to do?

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Posted 7/23/2016 2:29 PM (GMT 0)
Hi all.

I "belong" to two other forums at HW. The depression forum and the chronic pain forum. Now I must turn to this forum for advice. I hope this is the correct place to bring this problem up.

about 15 years ago I was diagnosed with BHP. about five years after the
diagnosis ( by my family doc ) I was " scoped " by a urologist, who agreed with the diagnosis , but because of my age ( 41 yrs at that time)
he said I should not have surgery.

A few months ago my trouble started to worsen , so my doc arranged a new visit to the same urologist. I was scoped two days ago, and now the urologist says I dont have an enlarged prostate , but that the " drain
hole" from my bladder is constricted.No BHP at all!

So I asked him what he thought should be done , and he said that he could open up this constriction for me , but that I would not ejaculate after that. The semen " goes back inside" is what he said happens. Because I only had a few minutes with the urologist after the cystoscopy , I said " yes, I want the surgery". Now , looking back at everything, including the urologist not spotting my trouble when he first scoped me 11 years ago , I am having second thoughts about having the opperation.

I would be delighted to pee like a normal ( non-BHP ) person , but do I really want to lose the ability to elaculate? And where does the semen go if it doesn't leave my body? Also , it has occured to me that I have been taking 0.4 mg of Flomax for 15 years without having an enlarged prostate. Do I still take it? I am really confused , and would be greatful for any advice, information, etc that you guys can provide.

BTW- I am 52 yrs old and single with no children.

What do I do? I am completely lost on this issue after finding out that my prostate is normal , but my bladder opening is the trouble. Please
ask any questions you want to , and please offer your thoughts on my
condition , and the opperation ( should I have it ).

Thank you,
Derwood.
Posted 7/23/2016 3:31 PM (GMT 0)
Being able to pee with a full stream would be more meaningful to me than the loss of being able to ejaculate.

I'm currently in that exact boat like a lot of guys here.
Posted 7/23/2016 4:07 PM (GMT 0)
Thanks for the thoughts Steve. I am not entirely sure about what to do; part of me REALLY wants to oee normally , but now I really dont trust the urologist after him misdiagnosing me the first time. I have an appointment with my family doctor on Monday , and hope to get some answers. I dont even know if I should still be taking the Flomax - does flomax work with a small eurethral opening? I sure dont know , but intend to find out.

Any more input would be greatly appreciated too guys.

Thanks,
Derwood.
Posted 7/23/2016 4:50 PM (GMT 0)
Derwood
I have no advice or suggestions except for one that should be obvious. If the plumbing in my house was bad I would want the problem diagnose and repaired by the best plumber I could find. Just a thought.
Posted 7/23/2016 5:12 PM (GMT 0)
Thanks Todd. I certainly get your message...this is what I am thinking too. Thanks very much for the input,it is appreciated. My doctoris going to be facing a barrage of questions when I see him on Monday. I will post the results of that appointment here, for anyone who may be curious.

Derwood.

PS- I ay be presuptuous about your name, but I was born in 1963
( too ? ) Thanks again.
Posted 7/23/2016 5:16 PM (GMT 0)
The kind of surgery they are recommending is called a "transurethral resection of the prostate" (TURP). They ream out the urethra. This can be done using a scalpel or a laser. I suggest you talk to an expert with each technique.

Usually the blockage is caused by BPH - the inner part of the prostate gets so big that it presses the urethra closed. Do they have any idea what caused it in your case if it's not BPH.

Most of the semen is created in the prostate and seminal vesicles. In the seminal vesicles it mixes with sperm coming up from the testes through a tube called the vas deferens. At orgasms, muscle contractions push the semen into the urethra and out through the penis. After a TURP, the muscles that push the semen down may be destroyed (in about 3/4 of men having a TURP), so the semen goes up into the bladder instead. This is called "retrograde ejaculation." Later you pee the semen out when you urinate.

If you think you may want to father children in the future, it's a good idea to to store your sperm at a sperm bank.

- Allen
Posted 7/23/2016 5:38 PM (GMT 0)
Wow, that is an excellent , informative post. The urologist didn't mention what type of surgery he would use ( scalpel or laser ) and he did not indicate why this happened. When I asked him " so does this mean my prostate is normal?" , he said " yes ". So I have just assumed that my prostate is normal sized. about 20 years ago I had a ( the spelling wont be good .. ) euratheoceole. They removed a golf-ball sized balloonage (?) of my eurethra that was a congenital
defect. So perhaps I was born with a small urethra too? I really dont know , but all of the info I am getting here is awesome , and will help me to ask the right questions when I see my doc on Monday.

Thanks for the TURP explanation ; the urologist said that term , but I didn't remember nor understand it. Also thanks for explaining how the semen gets out ( with my pee ). All of this info is excellent guys.

At this point , I am leaning towards not having surgery , but I have lot of questions to ask the doctors before I fully decide. One thing I really hope to find out is if the 15 years of taking Flomax was of ANY
benefit, or if it was a complete error.

Thanks very much Allen.

Derwood.
Posted 7/23/2016 6:34 PM (GMT 0)
I think there is such a thing as a urethral stent for urethral stricture, but I think it's a last-ditch measure after all other options fail, and I don't know how good it is. Doesn't hurt to ask about it.

Flomax, and other alpha-blockers, can cause retrograde ejaculation as well. The other kind of drug they give is a 5ARi (Proscar or Avodart). It shrinks the prostate when there is BPH to relieve the obstruction. Cialis has been found to be beneficial for "lower urinary tract symptoms" (LUTS) and is FDA-approved for that purpose (which means insurance will cover it). But if you have a congenital structural abnormality, I don't know how useful any of these medicines will be.

You can ask your urologist how big your prostate is - he must have taken an ultrasound reading of it at some point to determine the amount of urinary retention.

- Allen

Post Edited (Tall Allen) : 7/23/2016 12:38:58 PM (GMT-6)

Posted 7/25/2016 1:24 AM (GMT 0)
What is your PSA test history? Have you been tested regularly and what were the results?
Posted 7/25/2016 12:35 PM (GMT 0)
Hi guys.

Thanks for the extra information Tall Allen. I am going to sit down
now and write out my questions for my family doc ( Insee him this afternoon ).

Hi Fairwind ; I sont know what my PSA is , but I will ask my doctor this today as well. Thanks for the tip.

I will post a review of what I find out today on this thread.

Derwood.
Posted 7/25/2016 12:47 PM (GMT 0)
Hello Derwood and welcome. Sorry about your issues but I see you have already received some excellent advice and explanation.

I'll just add one other emphasis...let's see, you are considering surgery by the same doctor who previously misdiagnosed you? And your family doctor sent you to this same guy? My two cents is to run to an excellent and experienced urologist at another practice to get a second opinion before letting anyone touch you again. If you'll tell us your geography, there is a good chance someone here can give you a reference.

Jim
Posted 7/25/2016 1:00 PM (GMT 0)
Thanks for the info and the welcome Tudoock18.

This issue with the urologist ( misdiagnosis ) does have me concerned , and I may ask for anouther referal to a different urologist. I live in Prince Edward Island ( PEI ) , Canada ; a little
Island province on the east coast of Canada.

Yes , I sure have recieved great advice and information , and every bit of it is greatly appreciated.

Will keep you posted as this moves along.

Many thanks,
Derwood.
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