Anyone had the button TURP?
Posted , 12 users are following.
I'm trying to determine the advantage of this type of procedure over the traditional procedure.
1 like, 23 replies
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Notes on Anyone had the button TURP?
kenneth1955 william_90167
Posted
Rog615 william_90167
Posted
Not good high chance of retro if I'm not mistaken go with fla or second best rezum
JerseyUrology william_90167
Posted
No chips to remove
Possibly faster
Possibly more accurate/exacting ablation.
No possibility of TUR syndrome (absorption of glycine solution that can happen with a traditional TURP.)
MichaelVM7 JerseyUrology
Posted
Hi Dr.
For men like myself with prostates > 120 cc, TURP is not advisable because of risk of TUR syndrome.
Does button TURP offer us an option that is less invasive than open prostatectomy?
What are "chips"?
Thank you,
Michael
jimjames MichaelVM7
Posted
Check out HOLEP for larger prostates versus prostatecomy. HOLEP is not available everywhere, and requires additional training and experience, so make sure you go to a center and doctor who has done many of these.
Jim
jimjames william_90167
Posted
I think it's the wrong question for 2017. Yes, Button TURP has advantages over traditional TURP (see UroDoc's reply) but there are newer and perhaps better alternatives now depending on your individual condition. Some examples are Rezum, Urolift, iTind, PAE and FLA. All are less invasive than Button Turp and have fewer sexual side effects, including retrograde (dry) orgasm. But again, a lot really depends on your individual condtion. For example, someone in retention with a very compromised bladder may not do as well with some of the procedures versus others.
Jim
william_90167 jimjames
Posted
Wm
kenneth1955 william_90167
Posted
MichaelVM7 jimjames
Posted
Jim,
Thanks. This was informative.
I've followed some men here who've undergone PAE or FLA. There are mixed results, with some guys have great experiences.
I think Rezum may be an option worth further looking into, and the cost, IIRC, is less than PAE or FLA (both of which are cost prohibitive for my situation).
The thing that has me hung up on PAE is this: since the procedure blocks almost all of the blood flow to the prostate, what would happen if a man later develops an acute prostate infection? It is already hard to get antibiotics to the prostate as it is, and would not cutting off most of the blood supply make treating prostate infections that much harder?
PAE and FLA are more attractive due to their being so much less invasive than TURP or surgery, but what are the unseen ramifications later on if infection occurs?
Thanks,
Michael
paul29249 william_90167
Posted
I heard it was good, depending on what your BPH is.
If I had to folley I would have it done.
Doesn't seem to bother soom,I first did Urolift, Doctor didn't use anesthesia and couldn't complete so then he said if I was going to have anesthesia I should let him Greenlight me?
I then went to Mayo Phoenix and I'm scheduled for HOLEP, only 2% bAd things and hardly ever have to redo in future.
It has RE or retro ejaculation in 90% but the drugs already gave me that, I think just want to stop p*****g every 5 minutes. I'll wash hands and need to p**s again, on flights I have to get up several times, last trip to sunrise crater I think I p****d behind every rock. Pretty bad.
oldbuzzard william_90167
Posted
I agree with JimJames. If you have confirmed via testing that the size or position of your prostate is a significant factor in your symptoms, one of the less invasive procedures is a much better first step than Button Turp. The odds are very good that one of the procedures he mentioned would solve a prostate problem with no anesthesia, sexual side effects and a much shorter recovery time and much lower serious complication rate.
jay111 william_90167
Posted
Here's a discussion about it... Cheers
https://patient.info/forums/discuss/button-plasma-turp-4-weeks-post-538436
JerseyUrology william_90167
Posted
Everyone has a unique case, of course.
How large is your prostate? What is your maximum flow rate, and what is your post-void residual?
I always have my patients have testing for this information (at a minimum) before offering them any therapy.
I've found that in many/most cases, one of the minimally invasive procedures can be tried safely before something more aggressive such as a button TURP.
We have had excellent success with both Urolift and Rezum in many cases (and we are one of the highest volume centers for these procedures in the world, because of this.)
paul29249 JerseyUrology
Posted
Just curious, do you do in office without anesthesia?
My uro said he couldn't get into my bladder because of a angle, got flexible scope in but could not get Urolift tool into bladder, he tried for 20 minutes, said it was first time and And if I had to be put under Anastasia I should get Greenlight.. And didn't want to do Urolift in hospital so I went to Mayo Phoenix and scheduled a HOLEP.
I'll always wonder if Urolift would have worked if I had something for pain ,however Mayo said they found bacteria in urine sample, and put me on sulfur antibiotics. ???
JerseyUrology paul29249
Posted
We do Urolifts in our office.
I'd say roughly 80% have anesthesia (a board-certified anesthesiologist comes to our office) and 20% are done with just local anesthesia.
paul29249 JerseyUrology
Posted
Not even a pain pill.
Not sure I want a retry of Urolift with Doctor Who uses anesthesia or just get HOLEP and be done with this.
Started in 94 and been on drugs all that time .
jimjames JerseyUrology
Posted
Does the anathesia your office administers have the same incidence (or any incidence) of postoperative acute urinary retention, as in the case general or spinal anethesia? I ask because someone just posted about a case of persistent acute urinary retention, following urolift, and it sounds like he may have been voiding OK prior to the procedure.
Jim
JerseyUrology jimjames
Posted
william_90167 JerseyUrology
Posted
My Urologist said my prostate barely fit on his screen during biopsy last year. He said the size is one of the largest he has seen - 170cc. Makes things complicated. Have a folley right now because of total blockage & am on antibiotics. Other tests scheduled after I have the folley taken out in 8 more days
kenneth1955 paul29249
Posted
oldbuzzard william_90167
Posted
Button TURP is a big surgery. Something like REzum is not and they are doing it on big prostates now - the only difference is that they're finding the time between procedure and results is longer than smaller ones, which actually makes sense.
CIC (self cathing) rather than a foley is a much better way for most people to handle retention. You can live a pretty normal life that way, which will allow you more time to research all of your options. If I had a foley in me I'd want to get something done ASAP too. FWIW, I had alonger recovery than most with Rezum and had to self cath for roughly 20 days after and was able to lift weights and run.
Bruno59 JerseyUrology
Posted
I have a problem understanding prostate anatomy. In some illustrations, there is a urethra running through the prostae.
In some procedures, like TURP, HoLEP, in the videos, there is no visible urethra, and one can see the lobes.
In rezum, they puncture through the urethra, so there it is again. In RP, they cut the whole prostate out, like there was no urethra. Could you clear this please?
richp21 JerseyUrology
Posted
How do you test for max flow rate and PVR?
Thanks.
Rich