BPH for49 yrs

  Been to more then a few Urologists.Recently the recomendatioms have been turp. Not entirely happy since Im still potent.Would prefer to try the TUMA or the prostatron.Hope to find the procedure in the Phila PA area.Ive been voiding 1 to 2 qts each nite.Are those procedures available in the Phila region and is          it Medicare   approved.                                                                             Thank you in advance Nelson      
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Dear Nelson:
The risk of impotence (inability to obtain/maintain an erection adequate for sexual intercourse) following transurethral resection of the prostate is in the range of ten percent and may well be heavily influenced by the age of the majority of the patients undergoing the procedure (60+ year olds). The expectation following this procedure is that of retrograde ejaculation. This is the passage of semen into the bladder instead of out the urethra at the time of orgasm. The literature states that women do not feel the ejaculate itself squirting into their vaginas so from the standpoint of intravaginal sexual activity, there is not  a change in female partner sexual experience. Sterility is the ultimate effect upon the male. The orgasm still occurs and most patients report that it is unchanged.
Prostatron (transurethral microwave thermotherapy) and TUNA (transurethral needle ablation) are two of the newer modalities with which to treat the symptom complex known as prostatism (decreased and sometimes intermittent urine flow, delay before initiating urine flow, increased night time awakening to urinate, more frequent daytime urinating, etc.). They are not completely interchangeable with transurethral resection of the prostate (removal of much of the prostatic tissue performed through the urethra) and do not have a