Bipolar TURP - 6 month update

On April 4 of this year (2019) I had a bipolar TURP operation. I actually had it scheduled for the prior December, but canceled, in part due to negative comments here. As it turns out, canceling was a mistake. I spent four months becoming increasingly uncomfortable with my retention, getting up frequently at night, difficulty going back to sleep, and fighting frequency and urgency issues.

During the week before the operation I was instructed to stop taking all vitamins and supplements, and the night before did a complete body wash with antiseptic pads - all of this part of the pre op instructions.

I got up at 5am, and my wife drove me to the hospital, then checked in a 6am. I was asked to urinate and was barely able to get anything out. I could not wait for the operation. Pre op I was visited by two anesthesiologists, several nurses who asked me many questions about my health, exercise, vitamins, and any other issues that seemed important. I was offered a general or spinal, and was told that with a spinal It I might be unsteady on my feet for a while after the operation. I have had this before, but went for the general.

I was wheeled into the operating room and next thing I knew the whole thing was over - in the blink of an eye from my point of view. My wife and urologist were in the room checking on me. I had a Foley catheter in me and was being irrigated - didn't feel anything at all.

I got home 4.5 hours after I checked in and the only discomfort that day was from the Foley. I found I could not sit on a toilet seat - too much pain from the catheter, so when I had to go to the bathroom I learned to do it standing up. No big deal.

The operation was on Friday morning and I was instructed to take the Foley out on Monday morning. I did this in the shower. I have taken Foleys out before, but this one was big (20fr with double eyelets), so it was a bit painful briefly. A few hours later I went to the urology office for a "voiding test". I barely passed, but was able to void. If I had failed the test I was concerned that another Foley would be put in, and my urethral lining was very tender - was not looking forward to that. But, I was sent home with no Foley.

While the Foley was in the urine in my leg bag was pink and there were a few small blood clots and debris particles in the bag, but once the Foley was out, the urine returned to its normal color. Only a couple of minor blood clots came out after that.

Except for the Foley, there was no pain whatsoever associated with the operation and the post op weeks that followed. I waited for about a week and slowly began to resume my normal exercise program. After about a month I was back to my usual routine, working out three times per week on an elliptical trainer and doing some free weights. So issues, no pain, no bleeding.

Pre op my flow was very restricted, even on 2 Flomax per day. But, after the TURP my flow was stronger. The best I could do before the procedure was 5ml/second measured by peeing in a plastic beaker. After the TURP my flow had increased to 7ml/second. Gradually over the next couple of months I cut back to 1 Flomax per day, and now am taking 1 every other day. My flow is still good.

I have learned that just because the prostate is now much smaller doesn't mean that the bladder is immediately back to normal. After years of retention it takes the bladder time to "calm down", and I find my bladder is calming down. However, my urologist says that because of radiation for prostate cancer in 2014, I have "radiation cystitis", meaning that the cells in my bladder are more sensitive than normal. So, I have minor symptoms of overactive bladder. My frequency/urgency issues are much improved, but I am still getting up frequently at night. But, even this issue is better. I am now able to sleep in longer stretches, but the big difference is that before the operation when I got up at night, it took me at least 10 minutes and sometimes 20 minutes and many attempts to clear my bladder enough to get back to sleep. Now, I can clear the bladder in as little as a few minutes to usually no more than 10 minutes. This means I can get back to sleep much faster - a big improvement in the quality of my sleep.

Now, six months post op, I am happy I decided to go for the procedure. You may ask about retro - but that is not an issue for me since the radiation for my prostate cancer has generally wiped out my sex life. And, I am now rethinking my decision to have the radiation. If I had to do it all over again, I would have gone for the RRP, prostate removal. This would have saved me from five years of BPH torment. I had a PAE in 2017, and now this TURP, so if my prostate had been removed no PAE, no TURP, and no radiation cystitis. However, I might have had issues with incontinence. At least the radiation took care of the cancer - now 100% gone from all indications. My PSA is 0.2 and the tissue samples taken from the TURP showed no cancer.

Now, no incontinence issues during the day. I was having some dribbling at night, easily taken care of by padding my underwear with toilet tissue, but when I cut back on the Flomax, most of this issue went away.

I am still surprised by how many on this forum still don't understand that there are three types of TURP - monopolar, bipolar and plasma button. But it does seem that most here are now understanding the difference. This all helps to make a rational decision about treatment.

I never recommend any procedure, but in my case the TURP worked out well. My only issue remains the frequency of trips to the bathroom at night, but that situation is improving. My bladder is feeling better and this is encouraging.

In retrospect would I do this again? Absolutely, yes.

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