BrownBobby

The most important thing? Be honest. Embarrassingly honest. Leave NO question what you want and why you want it. Don't fake a medical history, and don't try to use language to hide it. You want a doctor willing to do it, and not afraid to talk about it.

I admit, I'm kind of worried at this point - I do genuinely hope everything has gone well for them, but I'd love to know whether or not they're doing alright.

A totally fair question, and one you phrased perfectly. I admit some fascination at the idea of no longer getting hard, but I didn't want to be impotent as a result of surgery. But like all operations, it was about measuring risks versus rewards. If I couldn't get hard but was incontinent, would that be, on the whole, better? For me, the answer was simple. There would be many ways to explore my sexuality besides an erection. But I had exhausted so many other options for being incontinent. And I ended up being right - the fulfillment of incontinence in my life is better than any momentary climax. But I was lucky - I get to have both still.

This is, I think, at the root of the original question in this topic. You did an better job than I laying out why the desire to leak something out of our genitals and the desire to have perfect control of what comes out of that same place are at odds with each other, and how there may be a much more pervasive desire at play here - the absolution of guilt. But that's not what they want to hear. And when someone tells them it, they start getting...less than coherent in response. Both urologists who operated on me asked the same question, as they consulted me on whether or not to get the surgery, even the external sphincterotomy: "If you leaked urine but couldn't get hard or orgasm again, would you be okay?" For me, the answer was yes. I think I suspect the OP's answer here, even if it might affect how they'd get what they want.

All very good points - and all reasons I made sure to talk with a lot of people before going through with it, including multiple therapists. With any permanent decision, ensuring you're doing it the right way is important. I'd add only one point - if you read through that list and instead of thinking, "Yeah, that sounds terrible," you thought "Yeah, the inconveniences like that are the point," incontinence may be more tied to your happiness than you think.

You know what? If you want to see what me actually attacking looks like, I'm happy to oblige. I was trying very much to avoid such things, but if you need to see it to know the difference between what I said and that, far be it from me to stop you... It wasn't this - wow, what a surprise! When I said "almost nothing," I wasn't exaggerating. The only effect was that, once I started peeing, I couldn't stop it. I had full control of when I peed, I had zero dribbling outside of that. And in three months, even that reverted to normal. I welcome you to actually look at the scientific literature for external urethral sphincterotomies - that's the term you're looking for, and you'll need to do more than just looking at the first two Google results to get at the data, but those rates I quote come from meta-studies of tracking the procedures over five-to-ten year time spans. About 30% of the time, nothing happens - not even what I got. About another 30-40% of the time, *something* happens, similar to what I had, but it goes away quickly. And in the last 20-30%, you get an effect that usually goes away within five years. The urinary system is excellent at repairing itself from such damage - which makes sense, given how important it is for the majority of people to not piss themselves. It's why I discourage people from seeing it as a panacea. I did too, before I did a bunch of research and got one myself. And the person least surprised by my lack of results was the urologist who did the procedure on me. I know it's not what you want. I get it. This is, in fact, the very crux of my point. If this is your guiding principle for seeking incontinence using surgical interventions, it's going to be a problem. It's really that simple. Any procedure that could cause incontinence has this as a side effect right out of the gate, *including* sphincterotomies. If this is your hard line that can't be crossed, I'd highly recommend finding other methods that don't involve physical or surgical interventions. Maybe options exist here, but I've yet to find any that I'd consider safe or sane. But I'm *always* happy to be proven wrong, if you can find evidence to support it. Not theories or google searches - evidence. I could speak to this, but I'd likely swear, and I'd rather not. Let's just say it's hilarious to me that you blame me of attacking, and not only personally attack me, but make wildly accusatory assumptions of my motivations. I'd claim it would be a sign that you are almost certainly not in the right mental headspace to be considering such things, but unlike you, I know I don't know enough about someone I've only met on an internet forum to make such a claim. So I'll instead say it impugns the character of your writing and makes me wonder if there is more at play here. Reddy's story is his to tell, and I know more than a lot of others about the details. I will only say that there is more in play with Reddy's account than the radical oversimplification that you present here. I did! It's also, unfortunately, irrelevant. Are there bad doctors out there? Of course there are. But overcorrecting so hard the other way, and assuming you can't trust anything that any doctor says because you default to the idea that they're greedy or have ill intentions, is just as unhelpful. That's where doing research is useful - actual research, looking at the same studies that the doctor are, finding multiple sources to validate your claims, and using the knowledge others can give you to try to find a path forward. ___ I truly do hope you find what you're looking for. I just suspect you're going to be in for a long, rough road on your current path. But as I said before, I'm not going to try to dissuade you from it - not that I suspect I could anyway. Good luck, truly.

@superabsorbantpolymer - That's the thing - it didn't quite end up like that either. But I strongly suspect that's because there isn't a lot of research into "how do we purposely make continent people less continent?"

I'm thinking it's best I write a dedicated post summarizing it, but now that I'm nine months after my revision and almost two years after the first surgery, I wanted to just chime in again to say that I am absolutely, 100% happy with how things are for me now. Besides retrograde ejaculation, there's been almost no effect to my sexual function, and the stricture is now to the point where I only need to cath every 2-3 weeks to keep it from closing up again. All in all, I'd trade those in a heartbeat to be where I am now, a full-time pantswetter with no hope in hell of staying dry without another surgical intervention. For those trying to look at "But what if you just remove part of it" as a solution, let me caution you immediately that down those roads lie madness. If you want to hope you're the lucky 1 in 3 who first has any results from surgery, and then has those results stay for any significant length of time...then go for it. My original external sphincterotomy did almost nothing, and focusing on just the bladder neck and external sphincter was only a partial success. It took all three to get me here, but now that I'm here...I'm thrilled. If there are specific questions, feel free to ask away, but I'm basically happy to get to just...have incontinence be something I get to enjoy for the rest of my life as I deal with everything else.

I'll step in just to say this - I found *lots* of doctors willing to do what I was asking them to, with removal of the bladder neck and sphincters. And most of them were much less than what I paid. But finding a doctor that was licensed, had a reliable track record, and was willing to do everything as above-board as possible was very, very difficult. It felt almost like a miracle when I did find one, especially one that knew I wanted no control whatsoever when he was done. I still can't believe I found one. I sincerely hope @Peelee is okay, and that, like me, he ended up just being busy with life stuff after. I'd love to find other places to have this done, with doctors that start developing reliable track records. In the meanwhile...be careful out there, everyone.

I don't know what to tell you at this point - if you're truly this obsessed over the idea of doing absolutely nothing that could, in any way, affect your sexual function in even the most marginal ways...then I'd highly advise stopping trying to make this goal happen. I *did* have exactly what you said done first. And it did almost nothing. And that's not uncommon - there's about a 1 in 3 chance that only removing the external sphincter does nothing, and a 1 in 3 chance that function reverts to normal shortly thereafter anyway. If you want to hope you're one of the lucky 1 in 3 *and* you can find a doctor to do it, then by all means, go for it. This will be the last reply I type to you about this, not because I want to stop the conversation, but because I sense there is really no path forward here. You seem to have made you your mind very definitively about what you want - and that's fine! But that also means accepting what the consequences of wanting that are. I wish you all the best in trying to find some solution here - but I suspect there won't be a satisfying one.

A good analogy is "If suddenly stopping a car while driving is so dangerous, how can anyone be trusted to drive to go up to driving speed?" The medications themselves are mostly safe, provided someone doesn't suddenly start or stop dosages of them. Is it possible that doing so does nothing? Yes, absolutely. But it's definitely a medication you wouldn't want to suddenly start and stop unless you had an expert on hand (similar to how you wouldn't want to suddenly start and stop a sports car if you weren't with an expert driver or in a controlled area.) And welcome to the fun world of creating protocols and playbooks! This is what I've been advocating with medical professionals for several years now to try to create. The use of an SSRI doesn't factor that much into it, but the rest of your comment is rock solid and part of what my therapists did when helping me with all of this. To summarize their findings: - I have this desire and have had it for a long, long time - This desire isn't caused by some other issue or trauma in my life that, through treating it, might also get rid of this desire, and - Not being able to work towards fulfilling the desire makes my mental health worse (and likewise, working to fulfill it makes it significantly better). In working with all of them, I explained everything else I did along the way to try to become incontient, including the more dangerous things I tried. That is partially what led to them being in support of more permanent interventions like surgery. As an irony, it's finally getting this surgery that might lead to me finally getting off my medication. For once, I don't have a huge weight on me mentally as I try to fight through the rest of the things in my life. For me, it was life-changing in the best possible way, and has already helped me begin dealing with other things in my life more effectively.

I'm checking, because this is VERY important - did you just stop taking it after talking with the doctor to suddenly stop the medication, or because you decided you just wanted to suddenly stop so you did? Going through sudden withdrawal of any SSRI/SNRI has very serious effects, none of which are particularly fun. What may look like "the word suddenly feeling different" is just as likely to be a significant imbalance in your brain chemistry and neurotransmitters - these things need to be tapered off of to avoid some of the more severe side effects. This caution isn't coming from nowhere - having watched multiple people in my life swing on and off their medications because "they just didn't feel like they needed it anymore" or "it just felt like something I should stop" and then get into very, very serious mental crises...it's not good. I've been on one myself for ten years, and while I definitely do plan on eventually trying to stop taking it...it sure as heck will only happen with a doctor there to help me do it. That, too, is part of making sure I don't endanger myself. Just as worrying though, @Reddy, you're swinging between thoughts about bowel incontinence with even more intensity than before. From "It can't be all bad" to "I don't want to poop myself" to "Pooping myself shouldn't stop traveling" and so on...are you having any trouble with thoughts like this outside of just this? I've seen similar thought patterns before and...well, saying you stopped your SSRI lines up very much with what I'd expect from those patterns. I'd potentially avoid making any major life decisions currently and seek professional help if you can - and I don't say that lightly. Again, I know I risk crossing a line and breaching sensitive topics...but your safety and well-being matter to me enough to take that risk. Once you DO have that professional help...I'd absolutely talk with them about this desire before you even consider moving forward with potential incontinence. I (and a few others who have had the bladder surgery) have had amazing outcomes, but we've also grappled hard with what things would look like after, lived as though we were that way for significant time before deciding anything, and accepted the expected results of said procedure. I am VERY thankful for the professional help I've had in making those decisions (including a BIID researcher, funnily enough). If you can't talk now with people about what you've done and why and be honest...it's only going to get even harder as someone who's bowel incontinent. Like i said before, I'm considering it, but even then it's only after years of having messed my diapers. I know what goes into it - and you need to do LONG before you make that choice. I advocate for people wanting to be incontinent, and even for people wanting it to be permanent. But I also make it VERY clear that becoming incontinent WILL NOT solve other problems you might have. If you suspect you might have those problems...please, please get help for them. I've lost close people in my life because of similar struggles - including the dominant who introduced me to full-time diaper use to begin with. I don't want to see anyone else have a similar fate.

I see "Do No Harm" stated a lot, but the more proper way to phrase it is "Harm Reduction." Almost every medical procedure inflicts some harm on a person - scars, side effects, discomfort, etc. The goal is for the procedure's benefits to outweigh its harms. In the opinion of many professionals I talked with, the benefits for me far outweighed the harms. One therapist actually helped me talk through evaluating the doctor - not offering judgment one way or the other, but helping me lay out my research and reasonings for things. It became pretty clear towards the end that it was an opportunity worth taking, though. My current therapist is actually amazed that I finally am incontinent, after talking about it for so long. The best part is how little it comes up now, all things considered. It's something I'll mention the same way I mention work, or my friends, or family. But it also was their idea for me to look into helping others with this more actively - and honestly, I think I'd enjoy it. I wanted there to be a support system for those looking to do this, safely and sanely. Maybe that's something I should try to build for others.

Yes - in fact, multiple therapists have. It's why I flip my lid when people try to tell me that I'm "obviously seeking self-harm" or "being reckless with my safety" by doing this. I'm going to trust the professionals over Random Internet Poster #74. To quote them (and the letters they've written, on their professional letterhead): "[BrownBobby] has been seeking a way to effect this control for the majority of his adult life with little success. I feel confident in my assessment that [he] is oriented toward his own self interest and of is of sound mind to make the decision to have this procedure done." "At this time, I fully endorse and support you in having this surgery. My clinical opinion is that to not have this surgery would potentially put you at risk of taking alternate measures that would not be under the guidance and care of a medical doctor." "If you work with anyone in the future, please feel free to use me, or the other therapists who have evaluated this, to serve as reference points. Too often, when something falls outside of what might be considered normal, we pathologize it and try to "make it go away" rather than respecting the wishes of the individual."