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1 in 5 men who have TURP surgery end up wearing pads for the rest of their lives. Half never ejaculate again. And 2 out of 3 are back in surgery within 5 years because the prostate grows back. These aren't stats you'll find in the pamphlet your urologist gave you. They're buried deep in the follow-up data. My name’s Dr Michael Thompson. I spent 25 years as a board-certified urologist. I performed 400 of these surgeries before retiring. Let me tell you what the leaflet doesn’t. The 1 in 5 who end up in pads. They don’t find out they’re in that 1 in 5 until around two months after surgery. The discharge notes don’t tell them. The surgeon doesn’t tell them. They work it out at home one afternoon when they sneeze and the leak, that had been occasional for weeks, happens in a way they can no longer ignore. They don’t tell their wives straight away. They keep spare undies in the car. They start buying pads from a different Coles or Woolies than usual. They rearrange their lives around it. They stop heading to the pub on Friday nights because the walk home is too unpredictable. They stop going to the theatre because the second act is two hours with only a 15-minute interval. They stop going to church — the pew’s in the middle of the row, and they can’t leave without disturbing eight people. They pick dark trousers every morning without thinking. They keep a small bag in the boot of the car their wives don’t know about. They don’t mention any of this to their GPs at the six-month check-up. The GP asks if their urinary function has improved. They say yes. The stream may be stronger but bladder control? That’s a different story. The GP never asks that question, and the men never offer it. One man I operated on in 2018 was a retired accountant. He played golf every Wednesday for 22 years. He stopped playing in November the year I did his surgery. His wife rang me in April the year after, asking if anything could be done about ongoing incontinence. There was nothing. I told him at six weeks post-op it should improve. It didn’t. He’s now 68 and still wears pads daily. Hasn’t played golf since 2018. Another patient in 2019, a 66-year-old retired bank manager named David Howell, had borderline numbers for referral. His wife Linda came to every appointment. We scheduled his procedure in a seven-minute consult. Mr Howell had TURP in September 2019. Developed incontinence by month two. I said it should resolve. It didn’t. He sold his narrowboat because he couldn’t handle overnight trips. Linda stopped sending Christmas cards in 2021. A third man I won’t name was 71 when I operated in 2020. No family in Australia, lived alone. He developed significant incontinence. He stopped answering my calls at three months post-op. A social worker contacted me 18 months later. He’d become a recluse, stopped leaving his flat. No warning signs in his records. Three men. All one in five. The ejaculation issue: Half is generous; closer to 9 in 10 lose ejaculation. Men realise this three weeks post-op in the shower. Something’s changed but they have no words. Most don’t tell their wives; wives figure it out quietly. Neither speaks about it, creating a gap neither knows how to close. I’ve talked to more wives about this than anything else. One wife told me the change wasn’t about sex but withdrawal — he stopped reaching for her, holding her hand, making little jokes after 40 years. Neither understood why; neither had the words. I had the words — I’d written them on the consent form but never said them aloud. About ‘permanent’ side effects: Retrograde ejaculation after TURP is usually permanent. Sometimes partial reversal if underlying causes addressed. But clinical language and consent forms treat it as permanent. Patients should understand this. They don’t. The form says ‘possible side effect’, implying it might happen, might not. Clinically, ‘possible’ means likely or certain, depending on the effect. For retrograde ejaculation, it means nearly certain. Nearly certain is very different from possible. I never said that aloud. About the second surgery: Official literature says about 31 per cent of TURP patients need a second surgery within 10 years. That’s the low hospital number. Internal data at my hospital’s 5-year follow-up showed more men had a second operation or were scheduled for one by year five — two out of three. It’s worse than the published data because recurrence happens mostly in the first five years. The surgery removes tissue blocking the urethra but doesn’t stop three biochemical processes causing regrowth. They keep running straight after surgery — days, weeks, months. Tissue regrows. Patients come back. I knew about the mechanism but didn’t take it seriously as the clinical protocol didn’t require me to. I scheduled surgery when numbers crossed thresholds but didn’t tell patients it wouldn't address causes. For 25 years. 52 per cent of men honestly admit in five-year follow-ups they regret the surgery. More than half. Not because of recovery but because of permanent changes no one explained clearly before consent. Retrograde ejaculation. Erectile dysfunction hitting 45 to 70 per cent of men — some temporary, some permanent. Incontinence putting 1 in 5 in pads for life. Tissue growth returning. Second surgeries. These outcomes made me retire early at 58 — I was meant to work until 65 but couldn’t face guiding another man through consent with the knowledge I had. Especially after I developed the condition at 54 myself. I’d been on Tamsulosin, had the dose upped, added Finasteride for six months. My stream weakened. Night-time toilet trips increased. Numbers crossed thresholds. A private hospital colleague scheduled me for pre-op consult. I walked out. I didn’t sign the form. I’d sat in that chair 400 times over 25 years asking men to sign. The language sounded different from the patient’s side. ‘Uncommon’, ‘possible’, ‘routine’ — same words, different meaning. I’d read research not in my usual journals on three biochemical processes driving prostate growth and compounds addressing them at validated doses. I want to explain those processes as most men don’t know: First: DHT overproduction. After 40, testosterone converts to DHT at increasing rates. DHT acts like fertiliser on prostate, forcing relentless growth. Tamsulosin doesn’t affect DHT. Surgery removes tissue but not hormone causing regrowth. Second: Vascular narrowing. Hormonal waste coats small blood vessels like limescale, narrowing them over time. Less oxygen causes prostate inflammation and swelling. Neither Tamsulosin nor surgery clears vessels. Third: Nutrient deficiency. Prostate needs specific compounds to regulate cell cycle. Without them, it cannot slow DHT surge or inflammation. No alpha blocker or surgery addresses this. Three processes. None tackled by medication or surgery. All active after surgery. Hence why tissue grows back and 2 in 3 need second surgery within five years. Hence 52 per cent regret the first operation. I won’t share full clinical details here — they’re in my article. I created a protocol from these compounds, tested it on myself, and my urodynamic results improved beyond medication alone. My scheduled surgery was cancelled. I offered this protocol to patients with pending surgeries — many had theirs cancelled too. I retired 18 months later. Three urology journals rejected the research, and a TV interview was pulled on the day of recording. The article is free to read. It’s at https://go.usevelaro.com/ProstaVita/everyones-talking-about-it-dr-anna-jensen-from-australia-has-received-a-medical-award-for-her-groundbreaking-research-into-a-prostate-supplement-that-could-improve-the-lives-of-millions-of-men#next-step It takes about 20 minutes. The article explains the three biochemical drivers, compounds, doses, studies, why surgery and medication don’t treat the cause, and why I created my protocol. I want to be clear: I’m not saying surgery is bad. It’s a legitimate procedure for men who need it — men whose kidneys suffer from retained urine, men in complete retention unresolvable by catheter, men over 80 with severe obstruction unsuitable for alternatives. For these men, surgery saves lives. The 1 in 5 in pads, 9 in 10 no ejaculation, 52 per cent regretting it — most were not those men. Most were men in their 60s and early 70s whose numbers crossed referral thresholds designed to catch men genuinely in need. The threshold caught others too because it’s a blunt tool. I used it for 25 years until it nearly caught me. If you’re on Tamsulosin, If your dose’s been increased, If Finasteride’s been added, If a surgical consult has been mentioned or booked, you’re on that road. The numbers will cross threshold. Surgery will be offered. You’ll sit across from someone like me and be given a consent form. Read the article before that happens. If surgery’s still your best option, have it knowing you’ve made an informed choice. If not, the article shows the alternative and how to pursue it. Read what I wish every one of those 400 men had read before they sat in my consulting room. https://go.usevelaro.com/ProstaVita/everyones-talking-about-it-dr-anna-jensen-from-australia-has-received-a-medical-award-for-her-groundbreaking-research-into-a-prostate-supplement-that-could-improve-the-lives-of-millions-of-men#next-step Michael Thompson Retired Urologist P.S. The men in pads, the men who no longer ejaculate, the men scheduled for second surgeries — they’re real men. Most haven’t told friends or their GPs the full story. Most are reading this now. If it’s too late to avoid surgery, read anyway. The protocol might improve outcomes after TURP. It won’t reverse surgery effects but can stop tissue regrowth and second surgeries.