Bi-Polar TURP at Stanford - second Post

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...first Post is stuck in Moderator He!! due to an included link. I will delete the link and try again here.

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Okay here's the first update on my Bi-Polar TURP. Highly recommend Stanford University Medical Center Staff. They are very courteous, knowledgeable, well trained, and caring (to the point of pampering). *Proviso - I haven't gotten the Bill yet. 😉

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Scheduled for 10 am, went in to surgery about an hour and a half late. My procedure was set for 1 hour duration, but actually only took about 35 minutes. Uro later explained that not only did my procedure go very smoothly, he save 10-15 minutes because I had requested the Bladder Neck Sparring technique which means less time actually cutting away material. I spent the night (about 18 hours) with the Foley in with a constant irrigation of saline flushing my bladder. Didn't sleep until about 0300 and was awakened with "Morning Wood" about 0430 with a Pain rating of about 8-9 on the Pain Scale. Luckily that subsided rater quickly as I laid there tryin not to scream out in pain and wake up anyone within 2 blocks of the facility.

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They forced me to suffer with a 22 french Foley 3-way Catheter, saying that is the only size they use. If I had known that, I would have brought along a case of these 14 french, 3-way Foley Catheters. *Link had to be deleted to get this post past the Moderator.

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The damage and pain from the 22 french Foley was far worse than any of the other parts of my procedure. It has also left me with "Razor Blade" peeing, a Super "Fun" experience for those who have never had to pee through a ripped, chapped and injured Urethra.

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At any rate... I am now 3 days out, and seeing far less blood, lessening pain on urination, and was only forced to CIC "Self Cath" twice since the removal of the Foley catheter. Both times I managed to hold off until bed time.

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Will update at 30 days, 3 months, and one year.... if I remember. If not, just presume that I am doing well and went on with my Life. As always, I wish the very Best to anyone suffering from this (or other) dastardly afflictions.

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Good Luck Brothers,

Chuck

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  • Posted

    not there yet but you make me nervaus as one day that could be me.DId you have other surgeries in the past

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    • Posted

      No other procedures/surgeries previously.

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      I know it's normal to be nervous, but use that nervousness to help You make the Best choice for You.

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      I am Very Grateful to Jim and Ken for all their knowledge and encouragement on CIC. I'm certainly glad I had previous experience with CIC, especially when I started blocking up and couldn't pee after they pulled the Foley out. Otherwise I would be stuck with the Foley for a week, or two weeks, or more like some other folks.

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    • Posted

      I was stuck with a Foley for two weeks after REZUM and thought I would have to self cath but I lucked out. The peeing seems to be getting better after three weeks but still bloody at initial flow. I'm told it could take over two months before the urine is clear of blood. I think I am getting better but still too early to tell at three weeks. Thanks for your input.

      Vern

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    • Posted

      you make me nervous as one day that could be me

      You should not generalize based on one post. I had the same procedure, including 17 hours of continuous bladder irrigation, went home without a catheter and never had an issue other than the typical frequency/urgency and burning for the first couple of days. By 3 weeks, I had resumed all normal activity with my doctor's blessing. Nine months out and everything is still fine.

      Everyone is different. You have to go into any procedure with a positive attitude. IMO, anyone with a negative attitude is almost guaranteed to have problems.

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  • Posted

    Chuck: Thanks for the update. You play up Standford but nice doesn't cut it. When you are in pain, it should be relieved somehow. You should not have to experience it for long periods of time and they should have had a selection of sizes in catheters. I'm sorry you had to go through that and I hope and pray for your speedy recovery. I hope the procedure is a complete success. Keep the faith.

    Vern

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    • Posted

      Vernon,

      They offered me pain pills / medications of All flavors. I refused all of them. And then they even sent me home (4 hour drive) with Tramadol, an opioid / narcotic for moderate to strong pain. I ain't using that neither.

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      You are correct on them utilizing different sizes; verses stuffing up their "One Size Fits All" garden hose. But that's the way they were trained. I believe if I had brought some along, they would have considered my request.

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      Thank you for your hopes & prayers, I sincerely appreciate that.

      Chuck

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  • Posted

    Chuck: All I can say is, you got guts. I would have taken the pain meds and probably asked for more. It is not in my nature to tough it out through pain when there is relief at hand so hats off to you for doing it.

    Vern

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  • Posted

    Hi Chuck, can you elaborate some on the discussions you had with your urologist at Stanford regarding bladder neck sparing? Is this something they routinely offer on request? Does your median lobe/bladder neck anatomy have to meet certain criteria for them to agree to it? what was their overall opinion on it? Also, do you know if he used a button or loop electrode? Or maybe both?

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    • Posted

      Russ,

      I new I wanted to spar my Bladder Neck before I even went to Stanford. I wanted a PAE, but my IR Doctor said (after viewing the CT scan and Cystoscopy) that I wasn't a great candidate for PAE. My prostrate was 38, and they want it to be in the 50 to 100 range. Normal prostrate size is about 14. Some (mine) prostrates grow in-ward and squeeze the Urethra more than other prostrates; which can grow quite large (150) and still allow urine to pass through the Urethra. Although usually the back-pressures cause the Bladder to distend and get stretched out, when urine is not fully voided. Stanford said that I could have whatever I want... if they have it as part of their surgical procedures. Bladder Neck Sparring techniques are very common nowadays. I believe my Bi-Polar TURP was Loop. With possible Button to smooth out the final surfaces; but I will ask at my next follow-up visit.

      Chuck

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  • Posted

    Chuck,

    I had a bipolar TURP in April and did NOT stay in the hospital overnight. I checked into the hospital at 6am and was home by 10:30am with a 20fr Foley in place. That lasted for three days, and I removed it myself in the shower, then went to the uro office for a voiding test, which I passed. The irritation from the Foley was the only discomfort I experienced from the entire procedure. No pain, almost no blood once the Foley was out. The reason the doctors put in a large Foley is so that any tissue particles and blood clots won't clog the eyelet in your bladder, so my Foley had double eyelets. I had no blockage issues and few particles or blood clots in my leg bag.

    Looking forward to your updates.

    Tom

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    • Posted

      Hi Tom:

      I guess I'm not thinking clearly today, but why are tissue particles and blood clots coming out of the Foley catheter? As I understand it, the end of the Foley is inside the bladder and the operation was done on the prostate. I know that some procedures push the removed tissue into the bladder and then morcellate it, but didn't think that was the case for TURP. Or maybe it is as a method for removing tissue. Maybe you can explain it to me. Thanks.

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    • Posted

      Yes, I would also like to know why I still get blood in the urine three weeks post REZUM procedure. I thought the dead tissue was absorbed by the body, not flushed out through the urethra. Can somebody explain why there is still blood in the urine after three weeks?

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    • Posted

      Vernon:

      I think that would be different for you. Although Rezum does not destroy the section of the urethra that passes through the prostate (prostate urethra), it does puncture the prostate urethra in order to inject the steam. So the puncture wounds could still be causing issues 3 weeks later.

      But for my question, the urine is traveling from the bladder through a fully enclosed catheter and then out the penis. Unless the catheter has holes in it, I don't see how tissue from the prostate could enter it (for TURP, the prostate urethra is destroyed). It seems to me that any material coming out of the catheter has to come out from the bladder (but I'm not saying that that tissue is bladder tissue).

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    • Posted

      I am not a urologist, but after a TURP the bladder is irrigated for a while to flush out any blood clots and tissue. Obviously, some of these particles get in or remain in the bladder. I saw some of these in my leg bag - just a few, very small. Very few blood clots. When you mention morcellate you are talking about HoLEP. I don't think this is something done in a TURP. Big Foley's are always used after a TURP and mine had double eyelets. Someone here said they had a three eyelet Foley. The bigger the Foley, the more irritating it can be. I have had 6 Foleys in since 2014, so am used to process, but the 20fr was more irritating than the previous 14fr Foleys.

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