Benign prostatic hyperplasia (BPH) Surgery Options

February 26th:
Starting to see tiny scabs. No pink colored urine, so far.

February 27th:
More pink than usual at the end of a stream
Perineum feels swollen. Uncomfortable sitting in a car seat. Couch is ok.

February 28th:
One scab, no pink. Perineum doesn't feel swollen.
Continued urethral spasms for about 20min following an empty bladder.

February 29th: 3 weeks Post-Op
No pink as long as I don't push hard while having a bowl movement
No scabs
Continued urethral spasms - not lasting as long or as intense

March 1st - 5th:
No Pink
Continued urethral spasms - not lasting as long or as intense
Nocturia - Continuing to get up 4- 5 times per night to urinate

March 6th 11:30 a.m:
Delayed urination until Bladder was full. I do not get the pp dance, urgency to go feeling anymore . Just the pressure.
The stream is strong on the first void. Void stops, then requires pushing on the subsequent voids in order to empty the bladder fully.

March 7th 9:00 p.m.
1st experience with retrograde ejaculation.
Forceful ejaculation; burning, throbbing, and cramping from my scrotum back to my rectum.
I could feel the semen shooting back into my bladder.
No blood following the experience.

March 10th 2:00 p.m.
2nd Experience with retrograde ejaculation.
Confirmed retrograde (dry), although it didn't feel like it. No pain, no blood
Orgasm Intensity is about 70-75% of pre-op

Occasional urethra spasms
Occasional Perineum Cramps on left or right side, not at the same time. Occurs mainly on the right side.

Starting a Urine stream is quick and easy. Additional rounds of pushing required in order to empty completely.

March 15th
3rd sexual experience ejaculated about a teaspoon of Semen

Noticing slightly red urine drops only following a bowl movement.
Only notice the red when urine drops landed on the toilet seat.

Urine continues to spray to the right side (makes a mess), similar to poor flowing sprayer nosal,
instead of flowing like an open ended hose.

Occasionally, empty the bladder on the 1st void.
Most of the time, additional rounds of pushing is required to completely empty.

March 20
Urine flow spray is starting to reduce
Urethra spasm have reduced in frequency and intensity
- Spasms are felt anywhere from the base of the scrotum to the tip of the penis

March 21 -- 6 Weeks Post - Op
- Dry ejaculation continues
- Post-op Nocturia... 3 - 6 times per night with 5 being the average - Fluids stopped at 5 pm.
- Pre-op Nocturia..... 3 - 30 times per night. 15 - 120 minutes to void to the point I could resume sleep. 8-10 being the average - Fluids stopped at 3 pm.
- Urethral spasms continue with occasional perineum cramps (assuming overactive bladder)
- resumed very light gym exercise routine.
- 1st void doesn't empty the bladder completely, but I get most of it out.

Thoughts:
The surgery exposed how extreme my urine retention had become over the past 3.5 years.
A prime example would be Feb 9th. A full bladder was normal to me.
I didn't recognize that I had an emergency room issue (950 ml).
I felt pain in my back (kidney), but thought it was gas from the anesthesia.
I have recently tried to let my bladder fill to my Pre-Op levels in an attempt to reduce my over active bladder (nocturia) issues, but I can't get there. It becomes way to uncomfortable for me to hold it that long.
I can easily push on my bladder and not feel like I need to go. Completely, opposite of my pre-op days.

Hopefully, at 12 weeks most of my residual issues will resolve themselves. I intend to update at that time.

March 22
Stopped fluids around 5:00 p.m. Snack, around 7:30pm, of 10 chips containing 70 grams of Sodium.
Up three times instead of my usual 5, to go to the bathroom. Full each time.
A short delay requiring a small push to start the stream.
The stream sprays, not solid flowing.
In order to completely empty following the 1st void,
I am required to push on subsequent voids.

March 23
Retrograde:
Partial - more than 50% antegrade, did a hard kegel during orgasm. Close to pre-op intensity.
A couple of globs with some trace blood came out when urinating.

Nocturia
Repeated March 22 experiment with more salt
Stopped fluids around 5:00 p.m. Snack, around 7:30pm, of 10 chips containing 70 grams of Sodium. plus salted hard boiled egg
Up 2 times instead of my usual 5, to go to the bathroom. Full each time.
A short delay requiring a small push to start the stream.
The stream sprays, not solid flowing.
In order to completely empty following the 1st void,
I am required to push on subsequent voids.

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March 27
Nocturia
Rough night, stopped fluids and food at 3:30pm. NO snack or salt before bed
Urinating like a horse every 30 min.or sooner. This went on for 2-3 hours.
After falling asleep, I was up an additional 3 times.
For me, salt definitely reduces my night time bathroom trips.

March 28 & 29
Nocturia
In my failed search for a low dosage salt table, around 100mg, I ran across Cell Salt tablets.
They are small and melt under your tongue.
The tablet contains 12 different Cell Salts in 1 tablet.

Stopped fluids and food around 4pm.
10pm, I placed 2 cell salts under my tongue and went to bed
Up 2 times each night instead of my usual 5.
The cell salts appear to contain enough salt reduce my night time bathroom trips.

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April 4 - 8 weeks post-op
No visible signs of blood since March 31

Urine flow sprays if my bladder is not full and streams when very full.

Stopped, Cell Salts, April 1st. They increased the time to start a stream to around 30 seconds on my night time bathroom trips.
The cell salts contained antihistamines and pain relievers.
I believe the pain reliever helped reduce the trips to the bathroom and the antihistamine caused the delay in starting a stream.
Taking ibuprofen before bed is a common practice to reduce your bathroom trips, but it’s hard on your liver.

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