Bipolar Turp, GreenLight, HoLEP

Some posters experienced a lot of pain during the procedure.

I found that the pain from my Rezum was not that bad. I took 1 Valium and 1 Percocet an hour before the procedue and I was awake the whole time. Afterwards, I went out to lunch with my driver. I never took the remaining Percocets.

Most docs twilight their Rezum patients now so its much less of an issue. I was wide awake, it hurt a lot briefly, but drove myself home after the procedure. It was a bit sore that day, but by the time I went to bed that night I was fine.

I was lifting weights a few days later - and would do it again, even with the procedural pain. It worked and the chances of complications were/are very low.

Why do people ask strangers and possibly even Trolls for what is best for them rather than trust the opinion of the Uro's who have done their tests and know what needs to be done.

A question for the ages! I have asked the same question on this forum many times. I suppose our UK friends dealing with NHS don't have the options those of us in the US have, especially us old farts on Medicare. One of the problems with internet forums is that they tend to attract complainers. The only reason I'm still participating is because I had a very successful TURP and I feel a responsibility to counteract the people who badmouth it (usually those who have not had one.)

The other thing to keep in mind (for those considering a procedure) is that this forum is populated by mostly old men. If someone has post-op issues, we have no way of knowing if the patient's other health issues may be contributing factors to a less successful outcome or a slow recovery. I think one of the reasons my TURP outcome was good is that I'm in excellent physical condition (for a 70 year old). I am not overweight and exercise 6 days/week (running or lifting weights.) Someone who has other health issues might not have the same outcome.

I also stick around as do a few other regulars to try to be of help to newcomers but we all have a 'best procedure that worked for us and friends. I have difficulty in understanding some of the really bad outcomes from any of the well tried procedures. I do honestly believe that UK procedures done in hospitals with a team of urologists and full back up are preferable to some of the American procedures.

I was 70 when I had my GL and 79 when my Thuluium/Holmium procedure.

My first Uro did GL on a man of over 90 as he described it as a very gentle procedure.

People come to this group because they seek information. Based on the posts here, it would seem that many don't get good info from their docs. I've seen everything from out and out lies, to misguided direction based on what procedures they're trained to do, not which one is best for a particular patient. Of course most people here are old - BPH isn't a young man's disease. Some have health issues that could impact recovery or which procedures are optimal, some don't. Some are done with sex, some aren't. All that should be factored into what is the best first course of treatment for someone.

Also, many impute their results from a particular procedure to everyone else who might be looking for some insight. That's also misleading. Just because there are millions of men who are really happy with the old fashioned TURP, doesn't mean that in this day and age, it should be a first line treatment for most men. Nor do the Rezum failures imply that its a flawed or poor first choice for many men - in fact, its probably ideal for most with simple BPH - particularly if health problems create increased risk with anesthesia, or men who want to preserve their ejaculations.

Further, NO ONE SHOULD EVER use comments here to compute success or failure rates for any procedure. Everything here is anecdotal and very few men who had any procedure go as promised and got the relief they sought find their way here. What this forum will help with are introducing things like self cathing - which for many men is a godsend while they decide what to do next or wait for something better. It will also inform about how some procedures aren't right for certain physiologies - Urolift and PAE are not so good with enlarged median lobes for instance.

Men should so their homework, research real statistics and use this forum as one of many tools available to help guide them through the morass that is BPH treatment IMO.

Basic information is readily available on the internet and you don't need to come here to find out what GL, HOLEP or bipolar TURP are. Once a man has a basic understanding of the procedures/methods used to combat BPH, then he needs to know the questions to ask. Uros will usually respond to your questions - but they don't necessarily provide information on questions that a man doesn't know to ask. This is true of many aspects in life.

Because blogs like this have posters who have actually gone through procedures they can help OPs determine what questions they need to ask. To me this is the most important contribution blogs like this make.

rde, maybe you can find out why hoLep has better redo rate than Turp, and let us know. 😀

A later study showed hoLep redo rate is 1.4 % after 18 years. Talk about meeting the test of time.

Rezum is the best choice right now, if retro ejaculation is a big concern.

My interest started when I was told in January 2005 that I had an enlarged prostate 35 grms and I needed a TURP as a matter of some urgency ! By chance a UK journalist with the Telegraph had been told the same. He started to investigate the procedure and was not impressed by the results particularly TUR syndrome that was occurring and causing cardiac problems up to five years later.

I read a book The Prostate: Facts and Misconceptions by H Salcedo who after being Urologist to the US Navy was then in private practice. I had some correspondence with him and he advised against TURP and TUMT the microwave procedure not available in the UK that I was considering fitting in with a holiday in America or Israel. He was very pro the laser procedures being developed so I decided to wait for them but I didn't expect to have to wait so long.

At that time we had computer News Groups that are now little used and the BPH one was very active. For some reason I've never been allowed to give a link to it.

I actually still subscribe to it and have over 13,000 posts downloaded from it from 2003 to now. The earlier ones fell off the edge at some point.

Soon GL came on the scene and had great reports and patients traveling across America to centres doing it. One poster Patrick was probably the first paying patient after the trials and was a fountain of knowledge on it. Sadly eight years later he reported that he had prostate cancer.

So you see patients have been helping others for a long time. There is an American heath forum that used to have quite an active prostate Forum that I have not looked at for a long time.

Does ageism exist within medicare ? It does in certain areas of the NHS and I've encountered it in urology and accused them of it when tried to get me on medication and denying their department did laser surgery. .I hit the 85 barrier with my birthday on Sunday when many Orthopaedic surgeries start to be denied.

Serious life saving cardiology surgery is OK but they certainly avoid lesser ones like ablation that improves quality of life.

I have a very sensitive Vagus nerve that when stimulated during a colonoscopy put me back into AF. At that time I had a cardioversion that put me back into NSR and later had three offers for various types of ablation that I turned down. Next time a DRE stimulated my vagus nerve and I've been in permanent AF for over four years. I'm told that a cardioversion will not work as my right atrium is enlarged but if I have an ablation it will probably reduce the atrium size and a cardioversion would probably work. When I said I'd go for that I was asked why I wanted to be in NSR anyway if I can't walk. I can't walk without a rollator due to neuropathy from Fluoroquinole Toxicity Syndrome from the drug prescribed three times for prostatitis. I said the AF won't go away but sometimes the neuropathy does after some years.

Great discussion guys! My uro is recommending Rezum if the biopsy does not show cancer. but said my symptoms are too mild to do anything right now.