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Da Vinci for Turp??

Posted , 14 users are following.

jjjj57989
jjjj57989

I just had a cystocopy and it seems like I am headed for a TURP.

My local urologist seems quite competent but I am wondering if I would do better with a large medical center perhaps equipped with robotic surgery like Da Vinci.

Advice will be greatly appreciated.

0 likes, 94 replies

94 Replies

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  • bill69723
    bill69723 jjjj57989

    Posted

    Bladder neck obstruction may resolve following Urolift. If it does not resolve then medications or surgery such as TURP may need to be considered. Urolft is usually advised if the prostate is less than 100 cc's. Many urologist do not want to retool and learn Urolift, therefore advise against using it. As for PAE, at this time only radiologist specializing in radiology intervention perform PAE. It is not likely urologists will ever be accepting of this procedure and unfortunately if a patient decides to get a PAE and then later requires a urologist for new or recurring prostate problems, finding a urologist to help may in some cases become problematic.
    • cartoonman
      cartoonman bill69723

      Posted

      Just a slight refinement, Bill... this, from the Urolift site:                          

      The primary contraindications are an obstructive or protruding median lobe of the prostate and a prostate with a volume of greater than 80cc.

      My urolift surgeon said his guideline is 40-80cc

    • bill69723
      bill69723 cartoonman

      Posted

      There is apparently some latitude about size of prostate and I am not prepared to dispute prostate size requirements. I do know there is some latitude on median lobe size..
    • cartoonman
      cartoonman bill69723

      Posted

      Weren't we taught that size matters?  Oh, wait, that was "old-thinking."    But yes, I think there is some, err, "wiggle room."  My uro-doc looked at my records from 3,000 km away, and said he had a "hunch" that it would work in my case (my prostate was actually SMALLER than the minimum (It was just under 39gm/cc ; go figure!)... and then he invited me to fly out to his clinic for thre procedure.
    • william79680
      william79680 bill69723

      Posted

      While Urologists do not perform and are therefore generally not knowledgeable about PAE, I do not believe that a PAE would ever be problematic in getting them to treat unrelated prostate/bladed issues. One of the great things about a PAE is that it can be repeated if required and it poses no problems with pursuing other options such as Urolift or Turp later on should they be required. 

      PAE has been life changing for me. One year out now and I never have to worry about peeing anymore. GO with the flow!!!

  • tom86211
    tom86211 jjjj57989

    Posted

    Interventional Radiologists will NOT perform a PAE on a prostate that has had prior radiation for prostate cancer. 

    Also, NeoTract, the company that invented the Urolift, is currently doing a Clinical Trial on an advanced form of Urolift that accommodates prostates with median lobe issues. Again, if you have had any prior radiation to the prostate you would not be eligible for this trial. I just spoke with the company. 

  • ken18338
    ken18338 jjjj57989

    Posted

    I am sure that your urologist is competent. It is a simple procedure. I went in to the hospital 10 days ago. I had a catheter put in, now I am taking the two drugs instead of doing the turp. I hope that this will work. The urolift sounds really good too.

     

  • kenneth1955
    kenneth1955 jjjj57989

    Posted

    Jim  I had the urolift done 1 year ago today and all is great.  No pill and sleep all night.  Less done time and bleeding to  Take care  Ken
    • ken18338
      ken18338 kenneth1955

      Posted

      Hello, I have to take pills all the time, is the urolift covered by medical?
    • cartoonman
      cartoonman ken18338

      Posted

      Check with your insurance.  If you're on Medicare, it is now covered...
    • lester90053
      lester90053 ken18338

      Posted

      Medicare covers up to 80%. You still have to pay 20% unless you have supplement insurance.
  • bill69723
    bill69723 jjjj57989

    Posted

    I had the UroLift performed about 6 weeks ago and I went from just dribbling with FloMax to peeing like a firehose 2 weeks post implant of UroLift. Urolift exceeded all my hopes and expectations.
    • cartoonman
      cartoonman bill69723

      Posted

      Yay, Bill!  Another satisfied customer!  :-D

      In those first few weeks post-implanting of my Urolift in December, I felt like I knew the feeling of "BORN AGAIN!"  :-D

       

    • 1Romisz1
      1Romisz1 bill69723

      Posted

      bill,

      Where and with whom did you have your Urolift procedure done.  I am hoping this may do the trick, but my prostate may be to large.  

       

    • cartoonman
      cartoonman 1Romisz1

      Posted

      Just how large IS your prostate, Romisz?  My Urolift guy said 40-80gm was the range he liked to work in...  That said, mine was actually SMALL, at 39gm.... And he did it anyway.   Mine was done in Salt Lake City, btw....
    • 1Romisz1
      1Romisz1 cartoonman

      Posted

      Hello Cartoonman, I believe you told me about the MD in SLC that did your Urolift procedure. I have his name, and after my contract work in California that ends the end of May, I will give him a call cause I live in Colorado.  Also, I believe you live in Bethlehem, PA.  I own a house in Palmer Township, PA that I am going to sell, we are neighbors!  Robert

      I need to look up the size of my prostate, do not know the exact size, but will find out and let you know.  It may be to big for the Urolift, so I am keeping my eye open for other procedures. I have been wearing a catheter with a plup, no bag, for almost 2 years now cause I do not want a Da Vinci or a Turp.  There is that one MD I read here that is in the South East who goes through the rectum with MRI and obliterates the prostate that way which releases tensiopn on the urethra.  Dr. Siegal I think, that may be my salvation......

       

    • cartoonman
      cartoonman 1Romisz1

      Posted

      Hey, NEIGHBOR!  :-)  Most houses in Palmer are in the subeurbs...is yours?  Also, why the permanent cath?  

      Yeah, the size is critical!

       

    • kenneth1955
      kenneth1955 1Romisz1

      Posted

      Look it up on the internet It will tell you where in your city..Ken
    • cartoonman
      cartoonman kenneth1955

      Posted

      If you think that practice makes perfect,  a better likelihood that the doctor will be good may well be suggested by the number of operations s/he has performed.  I asked everyone I called (We had no one local in Summer 2015).  None of the NYC-area doctors had experience to brag about, which is why I flew to SLC for my Urolift.
    • 1Romisz1
      1Romisz1 cartoonman

      Posted

      The catheter gets changed out usually every 4-6 weeks.  Reason for this is that three different Urologists wanted to take out the prostate surgically, either by Da Vinci or finger, this did not set well with me, and I have been looking for a alternative since.  Urolift I hoped was a plan, but i think my prostate is to large.  So maybe the rectum procedure or PAE, Itend (?). etc. is a possibility.  Yeah, the constant changing of catheters sucks, but I have not occured any complications like UTI's or such.  I am pretty healthy, 61 years of age, as of now not sexually active, boo-hoo, and just attending to some of personal problemos which has overwhelmed me.  So I just hope a alternative to TURP is found.

      My home is located in a nice area of Palmer Township across from the fire station and up the hill off of Route 248.

      Robert

       

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