complet list/thread on bhp surgical options along with advantages and posible complications

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I was starting to make a list of all possible surgical options for bph along with advantages , what the procedure is better for (ie someone with large medium lobe) and possible complications. i thought id start it as a thread with all to add. if anyone knows how to make a sticky note on this thread please let me know so i can make it easier to read. (i'll start a separate thread on non surgical procedures in near future.)

TURP - Transurethral resection of the prostate

TUMT - Transurethral microwave thermotherapy

TUNA - Transurethral needle ablation

GreenLight /PVP - Photoselective vaporization of the prostate

HoLEP  - Holmium Laser Enucleation of Prostate

UroLift

Rezum

FLA - Focal laser ablation

Please free free to add any other procedures, advantages , disadvantages, etc.

thank you

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  • Posted

    Button Turp could be a separate procedure since it offers advantages over Turp such as less bleeding. 
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  • Posted

    Itind, Aquablation and ep (ejaculation preserving) TURP. Consider also adding CIC (self catherization). Not a surgery, but it is a procedure abeit done by the self and serves the same purpose as the surgeries when meds don't work are not tolerated well.

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    • Posted

      Not a separate procedure but more of a technique used with TURP where there is a specific intent to preserve the ejaculatory ducts from harm. Problem is not to many doctors are either knowledgeable or motivated to spend the xtra time in learning and in the surgery itself, so one really has to do some research and ask. I will post some studies on ep TURP later on.

      Jim

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    • Posted

      Thanks Jim. if you know of where i can pull advantages/risks, etc i'll pull and add when i have time.

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  • Posted

    It's too bad this software doesn't allow one to edit a post so your original list could just grow.  Prostate artery embolization (PAE) seems to have quite a few fans on this forum.  I started a thread on that process yesterday for people to report their satisfaction.  There are several other threads which contain comments from PAE recipients  and I suspect those that have had the procedure and are happy with it may no longer be visiting this forum. I will summarize my results in a few days.

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    • Posted

      yes lee, i was hoping to change the original thread. i will do updates to post as more get added.
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    • Posted

      It is usually the case that the satisfied customers hardly ever report back despite the help they may have had here.
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    • Posted

      My guess is that most guys who feel part of the community here will report their initial results but if they  are no longer having problems, there is little incentive to hang around.  Hard to know for sure. 

      And the "evidence" presented here is all anecdotal so no conclusions can really be drawn on the efficacy of any particular procedure.

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    • Posted

      That is the problem so many are repeating anecdotal rather than personal experiences.
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    • Posted

      Good point. A lot of confirmation bias at work with anecdotal accounts. Still useful however, as an adjunct to other research and a pointer to what to look out for. For example, when you read that a good  number of people got retro from a procedure that supposedly has a very low rate (talking rezum here) it might give you pause, epecially when all the very low retro figures were from trials where participants are cherry picked and the doctors may be more experienced.

      Jim

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    • Posted

      I do tend to put the success of my 2004 GL down to being on a trial where they probably picked out good candidates and did a bladder neck sparing technique. All three people I know who were early patients with different top UK uro's had very successful outcomes.

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    • Posted

      Which definition of anecdotal do you prefer ?

      An anecdotal observation is a factual account of an incident. The precise sequence of events is documented using descriptive language in order to describe exactly what occurs during a given situation. The setting and context are also carefully described. Subjective statements and judgments should be avoided during anecdotal observations. Therefore, a written anecdotal observation should provide the reader with a clear picture of the event.

      Or.

       based on or consisting of reports or observations of usually unscientific observersanecdotal evidence.  health benefits that may be more anecdotal than factual     

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    • Posted

      @Derek: That is the problem so many are repeating anecdotal rather than personal experiences.

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      I simply stated that "personal experience is anecdotal" by definition. Not that it doesn't have any value, I read and give it all the time, but it's not the same as say double bind scientific studies. Other than a very small sample size, confirmation bias is a big concern with anecdotal data, where people tend to filter facts to confirm their per-existting belief or confirm that what they did is the right thing and sometimes the best thing, i.e. procedure in many cases here. I think anyone interested can look up the respective definitions but your first definition sounds more like a primer in what a good anecdotal description should AIM for, but not what it is. The second definition you gave is closer to the accepted defintiion but I prefer this one:

      "@Derek: That is the problem so many are repeating anecdotal rather than personal experiences.

      -----------------------------------------

      I simply stated that "personal experience is anecdotal". I thought you were trying to say personal experience was not anecdotal. Am I misreading?

      As to which definition of anecdotal I prefer, the closest I've found related to our discussion is:

      "Generally, anecdotal information is based upon personal observation and may be incorrect in its conclusion that one draws from it. Even a series of repeated anecdotal observations is not the proper substitute for correctly obtained scientific data based upon a controlled experiment. ... This is an anecdotal conclusion."

      Jim

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    • Posted

      "Personal experience is anecdotal."

      Yes it is, unless accompanied by objective measurements.  Two guys might have the same increase in flow rate after a procedure and one might call it substantial and the other might say it's slight.  OTOH, regarding retro, you either have it or you don't so those observations are more meaningful however the percent getting retro from any given procedure can only be quantified by a clinical trial.

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    • Posted

      Or should we believe the man on the Clapham Omnibus ?

      The man on the Clapham omnibus is a hypothetical ordinary and reasonable person, used by the courts in English law where it is necessary to decide whether a party has acted as a reasonable person would – for example, in a civil action for negligence. The man on the Clapham omnibus is a reasonably educated, intelligent but nondescript person, against whom the defendant's conduct can be measured.  The term was introduced into English law during the Victorian era, and is still an important concept in British law. It is also used in other Commonwealth common law jurisdictions, sometimes with suitable modifications to the phrase as an aid to local comprehension. The route of the original "Clapham omnibus" is unknown but London Buses route 88 was briefly branded as "the Clapham Omnibus" in the 1990s and is sometimes associated with the term.

       

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    • Posted

      @lee: however the percent getting retro from any given procedure can only be quantified by a clinical trial.

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      That's why it's still considered anecdotal by definition whether it's an objective measurement or not. A Again, I'm not saying anecdotals are meaningless, I refer to them all the time, but they are what they are.

      Jim

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