Age 79. GREEN LIGHT 15 YEARS ago. Need something soon. What?

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Good health, but gradually increasing need to urinate and urine retention is on the high side.  I will need something done in the not too distant future and would like to plan ahead. When it becomes necessary, should I do another Greenlight Lazer, TURP, or......?

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  • Posted

    Hi Richard,

    How happy were you till recently with your Green Light? If it did what you wanted, then it's a very reasonable choice again. Don't particularly see the advantage of TURP over GL, especially if the GL worked out.

    There are newer, less invasive procedures out there, but the trade off is sometimes less optimum results against fewer sexual side effects such as retrograde orgasm. However, if you already have retro from your last GL, or if retro isn't an issue, then less of an advantage.

    If you haven't already, you might want to get re-evaluated in terms of bladder functionality with urodynamic testing as well as ultrasound imaging. If it turns out that the problem is significant to the bladder as opposed to the obstruction, then you might want to consider decompressing the bladder with six weeks or so of self cathing. You might even find that you're performing well enough after that to delay any decisions.

    Jim

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    • Posted

      This is a rare case where I will disagree with Jimjames. At 79, I would try EVERY other procedure that doesn't require anesthesia before considering Greenlight (and I wouldn't cosider TURP at all). At nearly 80, the risks of being put under aren't justified when there are less invasive, shorter recovery options that don't carry that risk. Urolift (if you don't have an enlarged median lobe), Rezum, FLA (focal laser ablation), PAE (same median lobe issues as Urolift) are all options to discuss with your doctor. What made sense at 64 with 2003 technology doesn't make as much sense now IMO, despite the good outcome.

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    • Posted

      As always, OB raises good points. That said, my understanding is that anesthesia risk is more related to conditions such as heart disease and diabetes and not age per say. But then there are the cognitive issues following anathesia but I think they also are there even with twilight. In any event, do check with your internist/cardiologist on this point. As to the less invasive options listed, again make sure that they will give you the best chance, because they always don't in the trade off for less sexual side effects which may already be a mute point. A good urologist and urodynamics might be helpful here.

      Jim

      Jim

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