Bipolar TURP controversies

Posted , 10 users are following.

As I have mentioned in posts elsewhere on this forum, I am considering treatment for my retention and severe nocturia issues and have to make a decision soon - up last night at 4 am with little sleep after - multiple trips to the bathroom. Just can't take this anymore. A bipolar TURP is one option that is available to me and covered by my insurance (Kaiser) and can be done at the local Kaiser hospital, two miles from my house. My other option is a second PAE, or Greenlight. Urolift wouldn't work due to median lobe.

So, on this forum there are two schools of thought about the bipolar TURP. The first is that it's a dangerous and terrible thing to do, and the second is that it works with excellent results, and the post operation effects are minimal. The negative comments seem to be coming from men who have not had this done, and the positive comments are coming from men who have actually had the operation.

Just wanted to point this out as I was reading more TURP comments this morning....

Tom

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  • Posted

    Beware of Green Light. As bad as TURP. I had it done. Suffered for 8 months after, then retention 3 years later for another 8 months caused by an auto accident, then recovered but not fully.

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  • Posted

    Good afternoon

    It is up to you what ever you have, A bipolar Turp is a little better than a regular Turp you just have to be prepared for the side effects. They are the same. If you read anything on Turp you will fine 8 that will not have that surgery to 2 that will.

    You can have anything you wants.

    Why did they say that Urolift is not good for you there is a new procedures that is called Midlift for median lobe. Which is working well. But there also have been a lot of men that have been on here that have been in retention there doctors told them the same thing that they needed a Turp But they also told them there is a 50/50 chance of it not working and they would have to still do CIC. So what is the point.

    Please do all your research before you decide what to do. Do a list pros and cons.

    I hope all goes well for you what every you decide. Good Luck

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    • Posted

      Sorry that it is not available to you.

      There are doctor all over the states that have been trained to do it. It is going to take time to get all the center open but then have doctors trained I got the information from the company. One of the guys that I got the information for had it done 12 days ago and he is doing great. He had 3 clips put on one side 2 on the other and 2 in the median lobe.

      It was approved a year ago by the FDA. There are 6 doctors in CA 5 in NY 2 in OR. and 4 in FL.

      I hope all goes well for you......Ken

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    • Posted

      Ken,

      I will attempt to see where the California doctors are located, but I am sure none are close to me. Actually, my sleep situation is getting to the point of crisis, so I need to move forward with something as soon as possible. I know you think this is not a good idea, but I just contacted my uro and asked if he has any surgery openings soon - I would go tomorrow morning if something opened up. Last night was really, really bad. I was up and down over and over again starting at 4am - no sleep after that. I am going to try to self cath - my last attempt was five years ago and didn't go well. I am concerned that the catheter may irritate the urethra lining making it nearly impossible to urinate at all. It's already close to impossible at night, which is why I have to go to the bathroom over and over and over again - just can't empty my bladder.

      I do have some catheter samples that I got in 2014. I have been staring at them for days but haven't had the courage to use one, yet.

      Tom

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    • Posted

      Tom

      Here are where that are at. Let me know if any of them is near you I can PM you the address and phone number.

      Napa, Sonora, Carmichael, Monterey, New Port Beach and Oceanside

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  • Posted

    Tom:

    To me your writeup seems to be correct. You mentioned earlier that you can't afford FLA. Given the severity of your problem, it seems like bipolar/button TURP or HoLEP are the procedures most likely to provide the result you desire. For me incontinence is a big issue, but I don't see RE as that big of an issue, esp. if you are suffering as much as you are at night (but everyone has a different outlook on this).

    I too am with Kaiser. As you progress with your decision, I would appreciate it if you could provide us with the name and location of your doctor and, of course, how you are progressing.

    Best of luck.

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    • Posted

      I haven't seen a negative comment on Bipolar TURP from an actual patient here on this forum. Some people put up negative comments because they think of the old TURP, with serious bleeding and long recovery time. However, retro ejaculation risk still remains. If RE is not an issue, I would go for it.

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    • Posted

      My list in preference order: Holep, bipolar TURP, Greenlight. Until I gather enough courage, because I am such a wimp, 😨 I self cath. Had I not found the solution for my occasional bleeding during self cathing recently, I would have committed to one of those already.

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    • Posted

      What caused the bleeding ?

      The Porter who wheeled me down the corridor to the operating theatre for my heart valve replacement said I was the calmest patient he had ever had. I didn't tell him that I'm not like that when going to the dentist but there I've had the worlds worst ones.

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    • Posted

      Solution for the bleeding: I changed catheters from the Coloplast Speedicath that Jimjames recommended to another brand. Speedicath brand is too stiff for me, and many others. Since then, I've tried many other brands and none of them causes bleeding.

      I have too much anxiety and I may not even survive just the waiting portion of the surgery. You sound like a cool guy.

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    • Posted

      I hear of pre meds but in four operations I never had one. It was straight into the theatre and mask over face. not even asked to count down from 10.

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    • Posted

      The only time I got worried was when having my first angiogram and put in little ante room outside the cath lab and abandoned for a good ten minutes.

      Self cathing is something I would not do. When I had retention prior to my GL I refused to do it.

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    • Posted

      Hey All

      They always gave be something before I went into the operating room. I remember my arms being tied down legs being put up and I think I got to 98 and I was out

      Even when I had my ablation done I knew everything that was going on. They had to shave my back and chest because they had to put stuff all over me and it would not stay on. I was in A-Fib that whole morning.

      The only problem I had with premeds was when I had my gallbladder taking out. I think they gave me to much. The surgery was only a hour but I did wake up for 6 hours. They keep me over night.

      Have a good night.....Ken

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    • Posted

      I had a PAE performed at Kaiser Hospital in Oakland by Dr. Hastings in the summer of 2017. It was partially successful - but due to median lobe structure didn't really help all that much. Now, things are worse. With Kaiser you are completely covered by any doctor in their system no matter where they are, so you just do research to find one who does what you want, and Kaiser has you covered. Total cost for my PAE was $250 - standard copay for the radiation.

      Tom

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    • Posted

      Dr. Hastings is the head of the IR department, and my wife and I really liked him. I was 100% satisfied with the job he did - thought he was really, really good. The only problem I had was that I am taller than 5'10" and so they had to go through the femoral artery, instead of the wrist. I went into the hospital at 7am, the PAE was over a few hours later, but by about 1pm I asked for a Foley Catheter because my bladder was getting really full lying in the hospital bed waiting for the puncture of the artery to heal - takes a while, and you have to be horizontal in the bed for hours. The nurse drained off 600cc of urine and I felt so much better!

      I was serious considering going back for round two, but he is scheduling several months out and my situation is getting so bad I can't wait that long.

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    • Posted

      Are you saying that you weren't allowed to urinate naturally until the puncture of the artery healed? If so, is that because they didn't want you to stand up and you had to lie horizontally for hours as you mentioned?

      How long did you have the Foley Catheter and did you need it when you were sent home?

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    • Posted

      rdemyan,

      Yes, I had to be horizontal for many hours until the doctor felt the femoral artery puncture point was healed - so unable to stand up and go to the bathroom. I was also really, really bored. By 1pm my bladder was getting really full. Foley was only in for a few hours, and they removed it when I was sent home. If I had this to do all over again I would have just left the Foley in until I got home and removed it myself. Normally, a Foley isn't used after PAE. If the patient is 5'10" or shorter they can go in through the wrist and avoid the femoral artery, but I was told it's too far from the wrist to the prostate in taller men.

      Tom

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    • Posted

      Hey Ton

      I know how you feel. When I had the ablation for my A-Fib I was on my back for 12 hours. I had a problem with the dye. Could not go to the bathroom laying flat. It does not work. The nurse kept coming in and telling me if I don't go they would have to put in a catheter. I was able to force myself just a little. I would have told them no anyway.

      Take care Ken

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    • Posted

      Yes. After I was released from the hospital my wife and I went out for a meal. I went to the bathroom but was unable to urinate. Possibly this was because the Foley had drained my bladder. By the time we got home (took a few hours, heavy traffic, 90 miles) I was OK. Peeing was slightly painful for a few days and I took an extra Flomax and Tylenol to help me through the first week - really easy compared with what some here go through with other procedures.

      If I had just left the Foley in until we returned home (about 4hrs after my hospital release) I would have been more comfortable. I have learned how to take a Foley out. The uro nurse gives you a little syringe and you remove the fluid from the little bulb that is keeping the catheter in your bladder. Once the fluid is out, the catheter just slides out. It's easy if you are in the shower and run warm water over your lower abdomen during the process. Just a short tickling sensation. Very, very easy. Much better than having a nurse yank it out of you in an office or hospital situation!

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    • Posted

      Hank,

      I have mentioned here on this forum that would try again to self cath before actually going in for another procedure. I did attempt this today, and failed. I used a 14fr hydrophilic catheter, the best, but only got it in about 1 inch. Really hurt, like being stuck with needles. Tried three times. I recalled that the same thing happened when I first tried to cath. Perhaps my urethral tissue is extremely sensitive. I know that when I have had Foleys put in the nurse uses Lidocane, then jams the cath in fast before you can scream. Anyway, not going to be doing this. I understand that if it were absolutely necessary that my tissue would eventually "toughen up" , but not today. Sorry to all who do the self cath.

      Tom

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    • Posted

      Magic by Rochester Medical (now Bard) 14fr hydrophilic antibacterial . Has a pouch of sterile salt water that you break and spread onto the catheter. I also have some antibiotic lubricant that my uro nurse gave me and put a little of that on the penis tip, but when the catheter went it hurt like h......!!

      Wonder if a 12fr would be easier and perhaps Lidocane gel (I have a tube of that - never used it)? I have long ago gotten over the psychological issue of pushing something into my urethra and bladder, but the pain was unbearable. It hurt to pee for a couple of hours after.

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    • Posted

      Hi, Tom,

      If you got the catheter in about 1 inch only I would immediately think "stricture", but that might be jumping to conclusions. For starters I would come down in catheter size. Try a Fr-12, or even a Fr-10, although this one might be too floppy and you wind up with the "wet noodle syndrome" - that is when the catheter just bends back in a 'U'.

      And, even though you're using hydrophilic catheters I would slather plenty of a water-based lubricant on the first 3 or 4 inches of catheter.

      I assume you have ruled out some kind of urethral trauma. High sensitivity is another possibility that you should consider.

      It might be an idea to have a doctor or urologist examine you and see what they come up with. Other than this somewhat lame response I don't know what to suggest and, not being a doctor, makes matters even worse!

      Above all else, don't try and force the catheter in. There is a reason for what is happening and you need to find out what before you can move ahead safely without injuring yourself.

      Warm regards and I hope you find an answer soon. alan86734.

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    • Posted

      Alan,

      The catheter was five years old and technically "expired" - possibly the salt water in the tube was not good. I would be open to re-lubricating another one. Last year my uro did a cystoscope and no issues. He was able to insert the scope and I only experienced very minor pain. Maybe my tissues have become sensitive. Next attempt I would take Tylenol before to dull the pain. Going to a 12fr is a another good idea. Thanks.

      Tom

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    • Posted

      Alan is right! Go to size 12 or even 10 is a good idea. Just make sure to use plenty of lube (even if it's prelubed) and go very slow. Make sure your fingers are clean. I don't know Bard but if it's made of rubber it should be soft enough. I favor Cure or Peco brands. Both are soft and very dirt cheap.

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    • Posted

      Tom, I would just skip the water packet and just use the external lube instead. I use an over the counter water based lubricant. Surgilube is also good. Lube about 1/3 of the catheter, from the tip. No need to lube the penis tip.

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    • Posted

      Hi, Tom,

      I think you've hit the proverbial "nail on the head"! If you have any catheter lube handy, such as Surgilube or any other brand for INTERNAL use only, and coat this onto the hydrophilic catheter; this should be O.K.

      Good luck, and wishing you painless insertions!

      Warm regards, alan86734.

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    • Posted

      Last year my uro did a cystoscope and no issues. He was able to insert the scope and I only experienced very minor pain.

      He probably inserted lidocaine into the urethra first though, didn't he? And he's got a better "angle of attack." And you were on your back. Lots of reasons this was easier than a DIY.

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