Thanks for ur advice which I agree.
But it is immensely helpful to me that Buster brought up the issue. Thanks to him as well! He appears to have done a lot of research also. He helped me to have a deeper understanding of HoLEP. Now I understand what causes stress incontinence and know what to ask Dr. Das.
But it is immensely helpful to me that Buster brought up the issue. Thanks to him as well! He appears to have done a lot of research also. He helped me to have a deeper understanding of HoLEP. Now I understand what causes stress incontinence and know what to ask Dr. Das.
Blayneb, sorry for your lengthy recovery. During the last Monty or so I picked up a bad infection in my crotch. It is no fun.
Regarding the internal sphincter it appears that it has a dual function to stop urine exiting the blader especially during stress and to prevent RE. Well it is Damaged during the surgery. Wheather it ever heals may never happen or take decades.
This is from a Wikipedia article.
“In males and females, both internal and external urethral sphincters function to inhibit the release of urine. In males, the internal sphincter muscle of urethra functions to prevent reflux of seminal fluids into the male bladder during ejaculation.”
Regarding the internal sphincter it appears that it has a dual function to stop urine exiting the blader especially during stress and to prevent RE. Well it is Damaged during the surgery. Wheather it ever heals may never happen or take decades.
This is from a Wikipedia article.
“In males and females, both internal and external urethral sphincters function to inhibit the release of urine. In males, the internal sphincter muscle of urethra functions to prevent reflux of seminal fluids into the male bladder during ejaculation.”
Yes it was very scary.
As for healing the human body can do marvelous things. I have been doing my kegels so the incontinence is nearly gone.
As for healing the human body can do marvelous things. I have been doing my kegels so the incontinence is nearly gone.
Good to see you've had such success Buster, gives me encouragement. I am trying to do my kegels as much as possible but progress is very slow. I have good days and bad. Just trying to stay positive. I drink a fair amount of coffee (and beer and wine to a lesser extent). I may not be doing myself any favors by doing that, not sure if that is a factor but I can't see cutting that out. I want to enjoy life.
As far as the internal sphincter, what you say makes sense. I experience stress incontinence to a lesser extent, I seem to hold pretty well when lifting or sneezing, coughing etc but at other times it just seems to leak out when I am just walking or going up stairs or even just standing, for no apparent reason. Not sure why this is. Seems worse after I urinate also. I try to empty as much as possible but maybe pushing those last drops out is not what I should do. Anyway I just muddle on!
As far as the internal sphincter, what you say makes sense. I experience stress incontinence to a lesser extent, I seem to hold pretty well when lifting or sneezing, coughing etc but at other times it just seems to leak out when I am just walking or going up stairs or even just standing, for no apparent reason. Not sure why this is. Seems worse after I urinate also. I try to empty as much as possible but maybe pushing those last drops out is not what I should do. Anyway I just muddle on!
You're very welcome DL. I look forward to hearing how your meeting with Dr Das goes. When are you going if I may ask?
DL, Blayneb is right on to say none of us are doctors. I agree it would be enlightening to have Dr. Das answer this question. I have never seen any articles that describes exactly what happens.
I asked one of the fellows at IU and he said the bladder neck was incised but Dr. Krambeck said no.
I asked one of the fellows at IU and he said the bladder neck was incised but Dr. Krambeck said no.
You know Buster, sometime I think everyone is different and they never really know exactly what they will do in each case until they get into each of us! That's kind of scary, but just might be reality.
I am sure it will come along. I do know that coffee is on the IU list as an irritant. It is also a diuretic so it is a double whammy. Since I get bladder spasms when I have caffeine I have almost gone to drinking water only.
In about April I did have several cups of decaf and immediately noticed the effect. Last week I was out to breakfast and had 4 or 5 cups of decaf without any noticible effects. It does get better.
In about April I did have several cups of decaf and immediately noticed the effect. Last week I was out to breakfast and had 4 or 5 cups of decaf without any noticible effects. It does get better.
Thanks for the encouragement Buster. I'll try drinking more water and less coffee, it can't hurt, and see what happens.
I know that we are all wonderfully made as individuals so there will minor changes to the surgery. Some follow the “cookbook” more closely than others. I am thinking of the adjustments that Dr. Miller has made.
I am still curious about Dr. Miller’s patients. There do not have the incontience issue presumably because she leaves prostate tissue around the bladder neck but they still experience RE.
I am still curious about Dr. Miller’s patients. There do not have the incontience issue presumably because she leaves prostate tissue around the bladder neck but they still experience RE.
Late September. Not easy to get an appointment with him if one is a first time patient.
I believe Dr. K was correct.
I am curious about the pros and cons of leaving a circular band of tissue near the bladder neck as well. One negative I could think of is this band will present some blockage. However, if most of the blockage is from adenoma further away from the bladder than it should have no effect. Obviously, if the patient has a large medium lobe, the Miller technique should not work.
I have spent a lot of time researching RE. Ejaculation is controlled by tissues near the verumontanum. It has nothing to do with the bladder neck. This had been proven scientifically.
I have spent a lot of time researching RE. Ejaculation is controlled by tissues near the verumontanum. It has nothing to do with the bladder neck. This had been proven scientifically.
To my current knowledge, for resective techniques, the competitors are HoLEP and aquablation. Aquablation trial results for prostrate size 30-80 and 80-150 hace shown that the functional outcomes are impressive and are neck to neck with TURP and that it has lower complications than TURP. Also there is a bonus of just 10% Anejaculation. The only thing that is lacking is proof of durability. From private email, dr. GIlling told me that incontinence is not an issue for aquablation. Obviously, the heatless operation is attractive, though I am not sure what complications would be reduced. But it should not hurt.
After hearing all these about sphincter damage from u both, I am having second thought about HoLEP. I do understand it was a special case of large prostate. At this moment, for me It does not seems to be an easy decision. Fortunately, I do have some time.
After hearing all these about sphincter damage from u both, I am having second thought about HoLEP. I do understand it was a special case of large prostate. At this moment, for me It does not seems to be an easy decision. Fortunately, I do have some time.
For me, my biggest problem with aquablation is there is little or no patient feedbacks. Unlike HoLEP, there are tons of feedbacks.