Passing Water

In my early 40’s, I began to experience difficulty urinating. I learned from a urologist that I had BPH, Benign prostatic hyperplasia. BPH is a benign growth of the prostate, that, over time, as it continues to grow, makes it harder and harder for a man to pee. A man’s prostate, like his ears and nose, continues to grow as he ages. Ok, who designed this system? BPH affects most men at some point in their lives. 

There are two options for BPH: surgery or medication. More recently surgery is divided into two categories: real surgery with micro-knives or lasers and a number of newer “minimally invasive procedures”. Before surgery is ever considered, medication is usually the first line of treatment. 

I held off BPH medications as long as I could. But a few years ago, peeing became nearly impossible. The medications that I tried helped somewhat, but no medication fully restored my ability to “pass water” with the ease of a young man. Rapaflo, one of the newer drugs, helped restore my ability to pee quickly and better than the older drugs I tried like tamsulosin, (generic Flomax). Over time, however, as my prostate has continued to grow, and it has again become difficult to pee.

Rapaflo also has a few lovely side effects. The first thing I noticed within a day of taking the drug was retrograde ejaculation. Retrograde ejaculation is when the ejaculate, at the time of orgasm, goes into the bladder rather then comes out the penis. I am convinced, even though my doctor disagrees, that I do not have retrograde ejaculation, but have no ejaculate at all. 

Another lovely side effect of the drug was my disappearing orgasms, which over time has almost ceased to exist. It is a sad state of affairs. This disappearing orgasm is not unique to me. I read the stories of other men online who described similar experiences with the drug. This does not mean that I do not have a sex life. I have a very active sex life with my partner, but I just do not have much of an orgasm. 

When the medication fails, surgery is the next option. The problem with almost all of the surgeries today is that they can cause erectile dysfunction and can ruin a man’s ability to have an orgasm. 

Two years ago, after a good deal of online research, I elected to have a minimally invasive procedure called Transurethral Microwave Therapy or TUMT, (Cooled ThermoTherapy), which heats up the prostate tissue so it dies and sloughs off, therefore creating a bigger tube through the prostate for the pee to pass. 

One of the important aspects of the TUMT procedure is that it does not damage a man’s sexual functioning. The procedure took place and within a week or two I did experience, for about a month, that it was easier to pee, before peeing became difficult again. There is a known failure rate with this procedure and I was one of the failures. Two months after the procedure I was again taking Rapaflo BPH medication. 

Over time, even with the medication, it has gotten harder to pee. I also want my orgasms back. After searching online again, I have settled on a new procedure called UroLift, which implants permanent devices to hold the lobes of the prostate apart, thus allowing urine to flow better. I am scheduled to have this procedure in two weeks. According to the manufacturer, the UroLift procedure does not affect sexual functioning, which for me is key.

As I approach this new procedure for BPH, it is not without trepidation. I do not like the idea of a permanent device implanted in my prostate. I worry about the long term implications of this implanted device. I also worry about lifestyle things like going through security at airports and being pulled aside by security because they detect metal in my body. I emailed the company that makes UroLift and was told that these devices are not picked up by airport scanning systems. I hope not. Generally, I am nervous about any medical procedure where my penis plays a central role. 

Fears aside, I have made up my mind to go forward and the procedure is scheduled. I am hoping to have my orgasms back and my urine flowing freely. 

We will see. 

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