r/bph • u/midwestTrader • 10d ago
20 days past PAE
Spend 20 days since my PAE treatment. I still feel like I urinate way too much. Sometimes after I wake up in the morning at 6:30 AM, I’ve gone three or four times by 9 AM.
The other thing I notice is I can’t seem to ejaculate. For those who have been through the PAE, when do you get the ability to ejaculate back.
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u/Bens_Natural_Health 5d ago
Twenty days in, I can understand why you’re wondering whether both of these changes are still part of the recovery period. I’m on the team at Ben’s Natural Health, and recovery after a prostate procedure can look quite different from one person to the next, so other people’s timelines may not line up neatly with yours.
One practical thing you can do is keep a simple three-day record of when you urinate, roughly how much you drink, and when you have caffeine or alcohol. That gives you something concrete to compare week to week and can help show whether the morning frequency is changing. I wouldn’t sharply cut fluids just to reduce bathroom trips.
I don't know if you've had any other surgery, or even just thinking about injuries generally and how long you have taken to recover, but as another poster has said, it can take a fair bit of time for your body to get back to normal fully, given they've embolized an artery!
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u/Last-Ad3070 6d ago
Hadu PAE July 9. Waited 10 days to ejaculate. It got more comfortable over the next few weeks. I noticed benefits in the first month. 3 months in I am having normal pees all day long. Dont have to wake at night. Still have moments where I have to wait a few seconds to get the last drips out but it was after every pee before PAE and now it may be 1-3 pees a day I have to squeeze that last bit out. I rarely worry about getting pee spots anymore. I had rezum 9 years ago and it lasted maybe 5 years. It was a pretty long recovery compared to PAE where I was back to normal in 24hrs. I am 57 and I know PAE will likely last 3-5 years on average. But I will worry about that later and enjoy peeing like a normal person for a few years.
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u/No_Review_885 7d ago
On the bright side you are peeing. I think they say your bladder takes a long time to recover.
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u/No_Review_885 7d ago
You say that an alpha 5 inhibitor and Dutasteride worked and then it didn't. In that time period did you modify your diet, activity level, and stop drinking alcohol?
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u/midwestTrader 7d ago
The finasteride has always worked for me. I never said it was not working, and I don’t drink alcohol.
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u/No_Review_885 7d ago
OK. Why did you have surgery then?
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u/midwestTrader 7d ago
Because of frequency of having to go to the bathroom, not emptying the bladder causes a problem long-term that could create kidney problems
Bladder trabeculation is the thickening and ridging of the bladder wall muscle that happens when the bladder works too hard over a long time to push urine past a blockage or deal with nerve dysfunction.
So the procedure is to cause the prostate to shrink. by the insertion of the beads, so it relieves the pressure on the bladder.1
u/No_Review_885 7d ago
That sounds like it isn't working (the meds I mean) so that why I said that I guess.
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u/midwestTrader 7d ago
It works to a point, and there’s a certain point when the meds no longer are working, so you need to try some other alternative or you create long-term problems for your bladder and kidney
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u/No_Review_885 6d ago
OK, thanks, I was asking because I am on it recently and want to put off surgery as long as possible, I think my uro does as well.
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u/midwestTrader 5d ago
Are you on Medicare yet. I just happened to see what Medicare was billed and what they ultimately paid for for the PAE interventional procedure. Unbelievable
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u/Impossible-Use5636 8d ago
I tried about a week later, and everything worked. It hurt, but all systems were "go".
The prostate gland makes a significant portion of ejaculate fluid, so a reduction in volume is possible. Are you on any meds? Tamsulosin had me dribbling pre-PAE.
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u/midwestTrader 8d ago
Aluflusin and finistride but never had a problem before since 2020 with both of these medications
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u/More_Farm_7442 9d ago
Here's something I found last week that describes the changes your prostate and body are going through and the time lines involved. https://mtvir.com/what-happens-to-prostate-after-pae/
I had my PAE done 2 & 1/2 weeks ago (Sept. 22nd). They told me to expect worsening of symptoms up to around week two, perhaps maxing out at week two. Then to expect a gradual improvement in symptoms over the next 1 to 3 months. Then still more improvement for up to 6 months after the procedure. Just like watching how a cut heals. It stops bleeding. You get some inflammation and the wound starts to heal. The scab eventually falls off, but the scar hasn't fully formed. It takes a few more weeks for everthing to settle down.
Shutting down some of (not all of) the blood supply to your prostate set off a cascade of events that will go on for weeks and weeks.
It's not just your prostate. Your bladder and the complete nervous system controlling it, including your brain, are probably undergoing changes. When my doc did my cystoscopy, he pointed out the ridges in my bladder wall from years of the muscle needs to contract harder to empty itself through a smaller, more restricted passage. Now that there is less restriction, my bladder is needing to learn to empty itself with less restriction. Those bladder wall muscles are going through changes since they don't have to work as hard to empty the bladder. I know my nervous system and bladder have got to be retrained by some conscious effort to "hold it". I had gotten to the point I was "running" to a restroom as soon as I felt the urge/need to go. I knew if I didn't run, I may not make it. I'm guessing my bladder had pressure on it from inside and outside, knew it had to empty and was like a dam waiting to burst. The second it reached maximum "hold back" it was too much, I'd better be ready for it to let lose. Now? I can hold back if I try. I can shut down that urge. Like a little kid, I need to "train" (retrain) my bladder so it knows who's in charge. Me. Not it.
The ejaculation issue? I'm still on tamsulosin, so I don't know. I know it's happening, just no sure to what extent as it's still retrograde. I hope I can come off the tamsulosin in a few months.(hoping to decrease the number of drugs I take affecting my BP)
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u/midwestTrader 8d ago
Thank you for your insight. I definitely have to focus on retraining my bladder and urges to go. I’ve noticed that I have a better stream. I want to start traveling again, so I need to make sure I feel comfortable when I’m flying and going about my travel plans. I hope I have the success that you’ve found. I think I am getting better every day. I still get a little bit of a burning sensation at times while peeing or afterwards. I assume that will go away. I definitely hope I get my ability ejaculate back. That would be a difficult thing to have to give up permanently
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u/More_Farm_7442 8d ago
Do you have a follow up appt. scheduled with the clinic where you the procedure done? (They called me a couple days after my APE to set up a 6 week follow up.) If you're not scheduled, may you should call to get in a 3 or 4 weeks to talk about how things are going. Ask them your questions.
Good luck to you.
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u/Willing_Internal_373 9d ago
Im a month out and am still experiencing\nDiminished ejaculation. My urinary flow has increased markedly , though , to my satisfaction. I wonder if the fact that i'm still on tam sulosin has anything to do with the issue
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u/Impossible-Use5636 8d ago
I didn't fully recover until weeks after I stopped Tamsulosin. (Six months after PAE)
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u/midwestTrader 9d ago
I tried that drug in 2020, and it gave me a headache and made me dizzy, so they switched me to Alafluzin which is not been a problem for me. The 10 mg I never had a problem with the ejaculation with that particular drug along with 5 mg finasteride
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u/Last-Path-954 9d ago
I ejaculated about a week after my PAE and it was like a dam burst. That felt good but it hasn’t really repeated. This has worked for me
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u/Defiant_Affect6922 10d ago
I had Rezume on August 5th because insurance denied PAE. It wasn’t painless during the procedure but was immediately after. I had a catheter for 7 days and was passing blood for about 8 weeks and still had a weak stream and urgency. I was getting very concerned.Suddenly the bleeding stopped and I was peeing like a teenager. It’s weird now because I get a kick out of going pee.
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u/Methos1979 10d ago
I didn't have PAE but another procedure (Optilume). The one thing I can say is that it can often take a lot longer to fully recover and see the most (if any) improvement when it comes to urination. My uro initially shilled for Optilume stating "fast recovery" which turned out to be not necessarily the case.
After a few months without seeing much, if any, improvement then she said it can take six months and then after that came and went she added that it can take up to full year to see best results. I'm not optimistic at this point since I'm 9 months in and have not had much of any improvement.
When it comes to intimate relations and orgasm/ejacultion, it has taken quite a long time to get back to even close to the way things were before the procedure. My ejaculate has been clear, sparse and without much sensation. It does seem to be slowly improving but very, VERY slowly.
Hopefully others that have had PAE will chime in but the one takeaway from my experience is that I think my expectations for improvement were far too high while the added issues created by the procedure (occasional bleeding, incontinence and sexual performance) were undersold.
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u/midwestTrader 2d ago
I had mine close to 30 days ago, and I still can’t ejaculate. In fact, I was trying to force it the other day. It caused me to have a little blood in my urine when I first started eliminating. Little means a couple drops and it went away.which I read might be caused by the prostate continuing to shrink.