After my cystoscopy, He said he will perform a two-for-one operation. TURB & TURP

 my urologist is highly regarded. He said during theTURP his resident doctors will be learning and assisting him in the procedure. Isn't the longer I wait to get something done go to damage my bladder? I just started taking medication for BPH. Wouldn't it be wise to see if the medication works before going for the surgery?

The more you are talking about what is going on is getting to me now. Your doctor whats to use you for training and a kinna pig.  He needs help.  Try the med's first before anything.  A good doctor would have told you that  Ken  

Hi Johnny, I just read that you said the resident doctors will be assisting him in the procedure, I strongly urge you not to allow any resident doctor to practice surgery on you as one mistake which a learner can easily make can leave you permanently regretting it for the rest of your very unhappy life, I know 100% that skilled surgeons themselves will never allow a resident doctor to do surgery on them, I realize they have to practice on someone but don't let it be you!  as ken has said.

Good morning Brain.  Only heard fro John a little pit.  He is going to have the lesion done by the same doctor.  I would not trust him.  He is going to have to look at the papers he sign very close. There is only one letter off from each TURB and TURP,  I am scared of what could happen but he will do what he want.   Only time will  tell. Let's hope it comes out ok and he does not do any damage to him where he has to have the turp done anyway.   Ken

Hi Kenneth, sadly most men have little or even no idea of what they are getting into until its too late and then have to suffer the consequences, we can all be grateful that there are men like you out there that genuinely care and are willing to  try to enlighten them in their dark path of confusion and lack of knowledge but thanks to medical forums like this and men like you we can continue to help their understanding, well done Ken but at the end of the day each one of us has to live with the decisions we make, lets hope he has made the right one.

Yes thank you Brain   That is true but I want them to make the right decision because they can't go back once it's done.   Some Doctors do not tell us everything that will happen with a procedure.  I know they are very busy but 5 minutes here or 10 minutes you can't get all your questions answered..  They just fly through We have to look things up.  To take care of us.  Take care  Ken 

Thanks for warning me. thanks guys. I don't think they're allowed to perform the actual surgery in a big hospital because the consent form would be just for the surgeon doing the procedure. I imagine the patient would be required to sign a consent that would state the resident would actually be performing the Surgery act. I believe they are may be allowed to assist the surgeon only.

Not true. Residents perform surgeries at teaching hospitals routinely. And the fine print in consent forms allows for it

That is why you have to read the fine print.  You can tell them you do not wish them in the surgery.  I do not mind if they come in to the room when they are talking about things but I do not want anyone but the  surgeon doing anything on me  No practicing surgery on me. Ken

Presumably the median lobe and bladder neck needed attention. So what procedure did you have if at all and if you had a bladder neck sparing surgery how did it affect your outcome.

Hi Derek, I had FLA which worked very well with no known side affects the surgery is a walk in the park its brilliant and no pain during or after, everything works well, it leaves turp in the dungeons of the dark ages-allow me to explain; turp in my case would have meant creating a large opening in my bladder neck which results in not only retro ejaculation but also it renders the bladder neck useless as a urine valve as it no longer seals urine from gravity leaving the only the lower prostate valve between you and permanent incontinence, now there is no urologist on earth that can guarantee the lower valve will hold urine as it depends on each person, also turp will often remove half of the prostate including the urethra inside the prostate that means if the surface they create does not remain water proof urine which is now in the prostate cavity 24/7 can slowly saturate the remaining prostate tissue and cause urine infection into the tissue and bloodstream, not to mention the potential serious damage they can cause to the penis urethra with scar tissue and what of all the important prostate tissue that was removed as since its now gone it cant do what it used to!

FLA is done via the anus with a much smaller laser and done under live mri so they dont do any damage to anything important as they can see exactly where they are under live mri they can be extremely precise and its so easy just lie down in a non clostraphobic mri then go home the same day the only hassle is having a catheter for 7 days then you are as good as new! in my case although the FLA was brilliant my bladder having been unable to do its job for years now has to be retrained to hold more fluid longer and not signal me to pee so often its gradually improving now that the urine pathway is not restricted any more, I flew from New Zealand to Houston Texas to get Dr Karamanian to do the FLA as he is the best in my opinion and VERY helpful, so ou see FLA is actually not really invasive as all it does is remove unimportant tissue that has grown and blocked the urine pathway but with no damage to the important bits-GENIUS,BRILLIANT, AMAZINGLY SIMPLE!

Hi Derek I should have added FLA keeps the prostate at a safe cool temperature by water cooling the prostate during the FLA and the computer tells them the water temperature, this technology is where we should be in 2018 the trouble is the urologists are not trained to use live mri and are not up to speed with FLA, they are aware of it but not trained or skilled in it so their natural instinct is that of self preservation with regard to their career, eg I visited a urologist who was a young robotic prostae surgeon I was shocked at his negative attitude toward FLA, knowing I was going to Dr Karamanian in Houston for FLA his exact words were " you wont come back any better off than before you left!"which reminds me I must tell him and all the urologists that were going to butcher me that FLA worked beautifully with no side affects and no damage!

Brain  I am happy that your happy.  He is a nice guy.  I have talked to him on the phone and he has e-mail me some answers to some of my questions.  Good luck and happy healing  Ken

Hey Brain.  Being you had it done can you tell me something.  When I talk to Dr. K  he told me he does the mapping of the prostate in his head.  Does he also show you what he is going to get rid off with some type of print out. Or on the copy of the MRI.  Just was wondering.  I know he his doing a couple of more men that are on here in the next couple of weeks.  He does work very hard for his patients.  Also is the tissue that is cut away flushed out of the body or does the body get rid of it in time.  I should have asked him when I talked with him last week  Thanks  Heal well  Ken 

Hey Kenneth, I don't know if you know this. But when you sign a consent form in the hospital for treatment like a procedure, after you sign it where does the consent and up in the hospital? I'm asking this because I signed two consent forms for the so-called two for one operation. During the same operation they were planning on taking out two tiny bladder lesions in A TURB procedure. The other procedure was a full on TURP. I canceled the TURP with the doctors office. They told me I would possibly be signing another new consent for the one procedure. Now I and thinking I should track down where the consents are at the hospital department or office and have them both revoked. My fear is when I going to surgery they may do both procedures anyway. Unless I'm just being paranoid. The doctors administrative assistant said it's only one procedure and they canceled the other.

John  I am sorry but I would not trust that doctor going in me for anything.  But if you insist .  I would ask for a copy of the form and make sure that it said TURP canceled and the date it was conceled.  .  Also when you sign that other consent form for the TURB make sure that is all it say's.  Also have them or you write on it no Turp for any reason. He can do anything to you he wants when your out.  You have to take control because I'm sorry.  I do not trust him.  Also I know that this is a teaching hospital.  I would tell them no one other then the doctor is aloud.  Ken   

Hi Kenneth, thank you yes FLA was the best option for my prostate bph median lobe and life is much better now, in answer to your questions, I presume since FLA can be done under live mri with exacting precision Dr K probably meant he knows before hand exactly what he needs to do for each individual persons prostate, he does not need a computer mapped out diagram to assist him as the live mri screen shows him exactly where the laser is and he knows exactly what he is doing, in my opinion he could well be the best FLA doctor in the world.

With regard to dead prostate tissue most of the dead tissue is removed naturally by the body, some remains but evidently is not a concern as I have not herd anyone that has had FLA experiencing an issue in that regard and neither have I but you do have good questions and Dr K is the best one to answer them, I certainly have no regrets and happily remind myself daily how glad I am to have had FLA and Dr Karamanian be the one to do it, kind regards Brian. 

As I repeatedly say I had GL in 2004 and Thulium//holmium laser in 2013 each without any problem and with bladder neck sparing.

It is my understanding that FLA was developed to treat prostate cancer so is it not a bit OTT for BPH, You and others having it are more fortunate than most in being able to be able to cross the world at your own expense to have the treatment of your choice while the figures say that a phenomenal   150,000 TURPs are still being done a year in the USA. 

 

I was told pretty much that when I refused TURP in 1994 and had GL. Rose tinted  spectacles was the expression he used.

I have heard that it is less then that.  That was from the Mayo Clinic But with all the Urologist and hospital in this world who knows.  But with all the new procedure I feel sorry for them men.  To each is own  Ken

Years ago there was a procedure called Transurethral microwave thermotherapy (TUMT) done through the rectum using water cooled microwaves. Presumably FLA is a very precise update on that idea.

Hi Derek, in my case the urologist surgeon who was going to do turp on me said I will become incontinent if I have turp, so regardless of the cost incontinence was a definite no no along with retro ejaculation and other sad consequences however if turp in some cases does not involve the above then it may be a sensible option but I believe FLA will eventually replace turp and hopefully become more financially available to the majority.

Brain only time will tell.  Dr. K is doing study's and he said by the end of the year.  Let's hope all goes well  and the cost goes down  Ken