(MEN) ENLARGED PROSTATE

Hi derek76

All that I was told is that it is quite large and that they have proof of my output from my stay in hospital.

When I see my GP next week I will ask him about this, as I have had bladder cancer and in remission and I don't want to go through it all again.

Mine was 35 grms when I first had symptoms in 1995 with slowing flow some retention but not really troublesome. I refused to have a TURP because of all the possble problems after it.

I took Tincture of Saw Palmetto, it did not stop it growing but helped with the flow.

 I knew that Laser surgery was being tried out in America and waited for an approved version to reach our shores.

By the time I had PVP in 2005 my prostate was 75grms with much slower flow, some urgency and bladder not emptying completely. I had tried the recommended drugs but had to stop them due to side effects.

After about four years it started to grow again and by the time I had Thulium Laser surgery last year it 125 grms. As someone said on this Forum prostates grow like weeds.

Presumably they know how big it is from scans and cystoscopies you have had during your bladder treatment.

When I saw the scan image it did look fairly large but they can be deceiving. I am down for more tests but still waiting to hear.

Before starting vesicare, I was like a dribble, with a bladder three parts full 24/7

But going back to size, when they used the camera, they had to come back a fair bit to see the size.

But as I said, I am waiting on the hospital for the next appointment.

Which area are you in? Some parts of the country are 'Laser Free Zones' with urologists totally against the newer treatments.

There is also TUMP (Microvave) and cyro surgery for BPH.

Hi derek76

I am in the west midlands area, but at the time of treatment I was living in Wolverhampton. I will be happy with any treatment.

TUMT is a waste of time. I had it. Two months of recurperation and need a Green Light Laser 10 months later. Every review by patients said it didn't work but I went ahead anyway.

I have heard that from others. The Uro's at my local hospital are still offering it along with a newer version of TURP. They do not do laser surgery but I found that one of the renal surgeons does and asked for him.

for me Tumt has actually made things worse.  my urologist does not do surgery and claimed 80% success.  I'm 7 weeks in .  I hold for 1 hour but need to go is 15 minutes

For the first 2 months after my TUMT, and again for the first nine weeks after my Greenlight laser, I was going 25 to 30 times a day. And I never tried to hold off going. I just went whenever I felt like I needed to. If I didn't, I would pee my pants. I used a beside urinal so I could go in the dark and get back to sleep.

After my (GL) PVP I had no urgency at all and was suprised at how seldom I needed to go during the day. However I was going about four times during the night and passing about 1.5 litres then.

Some one I know had his done at a London hospital in the early days of PVP on a Friday and was released overnight with a catheter in. He went back the following morning to have it removed and made his way to Kings X to catch a train to Inverness. He sat wondering when he would need to go and decided to try as train approached the Forth Bridge. A hesitant start and then a gusher and he let out a roar of delight at the thought of his reddish flow hitting the river below.

I've also had periods where I've gone more overnight than during the day. I wondered if my Circadian rhytms got thrown off. The bladder is supposed to concentrate urine at night to let us sleep. I've gotten up 3 to 4 times a night for years now so I use a 1 liter disposable urinal at night to let me go in the dark standing next to the bed, and get right back to sleep.

It sounds like your prostate grew an average of 10 grams a year or so in the 9 years between your GL and Thulium laser. I'm nearly 68 but if I live long enough I wouldn't be surprised to have to do the GL again, maybe more than once. The prostate is supposed to grow about 5% a year but I think people like us who had very large prostates may grow them quicker. Two years ago my prostate was supposedly 120G+ and my uro said he removed 70G leaving a 50G prostate.

I don't know how much was removed last year. When I asked the Uro he would only say, A lot!

At the follow up consult he suggested that I take Avodart to remove the need for another procedure in the future. Wary of it's side effects I asked, At 79 is that likely?  I could see his mind doing calculations and he replied, Perhaps not!

Good news and bad news! LOL.

Not sure as to what you are referring to derek76.

It was in reply to Bob120 and Good news and bad news.

Hi Derek,

I think during any turp all the parts of the prostate that are not vaporized are flushed into the bladder during the procedure. Maybe your urologist spent the extra time making sure he didn't leave any pieces of prostate tissue behind in the bladder. I've read of cases where a piece of tissue left behind in the bladder during a turp will block the flow post operative.

I was Laser not TURP but in each procedure they do flush the bladder out.

In the two weeks after my last one I was passing 'debris' Some pieces were quite big and blocking the catheter and I was squeezing the tube to force them out. In fact as soon as I got home it was starting to affect the flow and I phoned the hospital who asked me to come back to asess the situation.

Previously the liquid used during TURP could cause TURP Syndrome:

A rare but potentially serious risk associated with a transurethral resection of the prostate is known as TURP syndrome.

During the procedure, it is necessary to pump a fluid called glycine through the urethra to clear away blood and debris. In cases of TURP syndrome, the glycine becomes absorbed into the bloodstream, leading to a potentially dangerous build-up of fluid in the blood.

"Initial symptoms of TURP syndrome include:

feeling or being sick

disorientation

dizziness

headache

swelling of your abdomen

slow heartbeat (bradycardia)

Left untreated, additional and more serious symptoms can develop such as:

twitching

seizures (fits)

shortness of breath

blue skin (cyanosis)

heart pain

coma

If you start to experience the symptoms of TURP syndrome during your procedure, the surgeon will stop the surgery, remove the resectoscope and inject you with a diuretic, which is a type of medication used to remove fluid from the body.

Nowadays, the risk of TURP syndrome is estimated to be less than one in 100. It is likely to become even lower if a new method, known as bipolar TURP, is used, which does not involve pumping water into the urethra."

After my bladder resection I had a lot of clots. In the hospital they used a plastic syringe the size of a Turkey baster to suction clots out of the foley. I took one home with me and it was a godsend as the foley would stop up with clots every few hours. All I needed to do was disconnect the hose connected to the foley, insert the syringe into the foley output, and suck out the clots to clear the line. When I hear of people who have no after effects from their laser or turp I just think they are pretty lucky.

After the GL laser I went back to normal life from day two with the catheter only in overnight. Apart from the odd blood clot my urine was clear after the fourth day.

My recovery would would have been quicker after the Thulium Laser if the ward team had let nature take its course rather than send me home on day two with a catheter and tell me to come back in two weeks.

I got a catheter acquired infection and all the time the catheter was in my urine was pink. The moment it was taken out my urine was clear.

When I had my follow up with the surgeon he said that his instructon had been to only have the catheter for a week. 

 

After my GL I had the foley cath in for 3 days and removed it myself when i started peeing outside the cath (same thing happened to me with the TUMT). After the GL had eye popping bladder spasms every time I peed for about 6 weeks. Had terrible urgency (less than 10 seconds to get to a bathroom) and frequency as well. Took 9 weeks for everything to quiet down. Six months later needed to have scar tissue removed and self cathing every two weeks, then once a month, for a year to keep scar tissue from forming. At the end of the year developed a hematuria in the prostate and bladder neck that needed emergency surgery, and also had bladder stones removed and a resection of the bladder mouth. Been good for about 8 months now. Keep waiting for the other shoe to drop.

A friend of mine had sex on day six after his PVP. I cautiously waited for two weeks.

One of the UK's top two urologists who first started doing PVP said that only 7% of patients have any problem after the procedure.

I lasted 10 days. I don't think it had anything to do with the recovery. I wanted to see if I had retro (I didn't).I think they have done about a half million lasers treatments for bph. So that 7% is about  35,000 with problems. More than enough to fill up the forums. 7% sounds more honest than in the US where they claim a 95% success rate. I'm guessing their definition of problems is not having a follow up procedure within a year or so..But  I needed two additional procedures within 18 months. For me it was successful in reducing PVR and eliminating complete retention. But the symptoms of LUTS including frequency and getting up at night were only improved about 50% from 5-6 times a night to 2-4. Daytime frequency improved from about every 45 minutes to every 2-3 hours or so. A big improvement, but not the picture painted in the brochures. 

The other TOP UK urologist to start doing PVP here told me that initially they thought that PVP was a very quick and simple procedure but as time went on they realised that it had to be done with more care. Quite a confession.

I may have said in one of the other conversations here that the surgeon who did my Thulium Laser treatment last year was totally against PVP calling it a purely commercial procedure, not a cure.

I commented that I had watched a Youtube video of him doing a Demo to a German team of urologists.

That was just a small prostate he replied but yours will be more of a challenge.

The team at the hospital where I had my PVP in 2005 thought that it was a great procedure but have now abandoned it in favour of HoLep laser but without even considering Thulium laser

If you read the Pubmed studies of the last couple of years, the Thulium, PVP, Holmium lasers vs. the original TURP, all seem to get similar results. My urologist only does the PVP, so that was the deciding factor for me. I like him and he accepts Medicare as payment. Lots of urologists don't, and many urologists (mine included) have a full patient roster and don't accept new patients.  I think all the procedures are roughly the same in that they either burn or cut a channel through the prostate. They remove the prostatic urethra, and they cut the bladder neck to a greater or lesser extent. It's a fairly rough procedure, not like eye surgery or heart surgery. And they hope the removal of prostate tissue will relieve the symptoms of LUTS. But women have LUTS too, and they have no prostate.