Do I need a TURP?

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I am 72 years old and, other than BPH, in excellent health. I take tamsulosin (.8mg) daily. My voiding is often, but also highly dependent on my fluid intake throughout the day. I can usually make it through the night with one trip to the bathroom. My urine stream isn't strong, but it's not a dribble either. I have never experienced an inability to void, have no pain when voiding, have no leakage and have never needed a catheter to empty my bladder. A problem I have is that at my regular visits to my urologist I usually show on the ultrasound that I'm retaining a high level of urine, sometimes as much as 75%. For this, my urologist is insisting that I have a TURP. He is concerned about kidney damage. I monitor my voiding and usually void about 27 oz in a six hour period. This is average. I feel that I am managing my BPH fairly well and unwilling at this time to undergo major surgery. I would appreciate hearing someone else's opinion before I get a second opinion from another urologist. Finally, my doctor is not at all keen on any alternative treatments. He says TURP is the only way to go. Thanks.

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  • Edited

    I hope this is a helpful update...

    After careful consideration and following much research, I had the TURP surgery two weeks ago. The surgery was performed by my urologist at our local hospital. The surgery went very well. I was made very comfortable with an epidural and general anesthesia. After the surgery I had no pain...only discomfort that was easily managed with Tylenol. I spent the night in the hospital and for about 20 hours my bladder was irrigated through a catheter. I went home with the catheter (on Friday), spent a long weekend at home with the catheter and returned to the doctor on Monday morning to have the catheter removed. The ultrasound done on Monday afternoon showed no urine retention at all so I go back to the doctor in a month. The doctor said that the continued blockage caused by the BPH has caused the detrusor muscle to develop trabeculation of the bladder (hardening) that will take a long time to correct. While my bladder will probably never fully recover, he thinks that, in time, I'll be okay and my urination will be very manageable both in frequency and adequate emptying. I am already seeing signs that the surgery was successful. My stream is strong and, when done, feel that my bladder is empty. It has been a long time since I've had that sensation. The "urge to go" is very manageable. While I experience a little sensitivity when I go, the discomfort doesn't last and it is getting better every day. I am still on light activity with no heavy lifting, but I feel like I am back to normal.

    So far, I am very please with the results and wish I would have done this earlier.

    • Edited

      Hi Jay, glad to hear your recovery is going so well. I'm 3 months past my own TURP. and, like you, I'm extremely pleased with the results. However I experienced much a much more severe recovery than what you are describing. It took at least five weeks for the blood and tissue release to clear up. And until the eighth week for the pain to subside. I was really surprised at how brutal the process was - guess I just got unlucky.

    • Posted

      I am so sorry you had to go through that and really hope the bad days are behind you. The good news is that you came out on the other end of this and will, hopefully, enjoy uninterrupted sleep and the ability to enjoy activities without planning your schedule around bathroom breaks. Best regards...

    • Posted

      Has the TURP resolved the nighttime urination?

    • Posted

      Yes, to a certain extent. I was told to expect frequent urination for a while, especially because of the extraordinary amount of liquids that I am drinking. They tell you to drink a lot. The first week after the surgery I was up 3-4 times a night. Now, twice...some nights only once, so I think it's getting better. Also, pre-TURP, night time urination would take 2-4 minutes to finish because of the weak stream. Now, much stronger stream and 15 seconds+/- and I'm done with no feeling like I haven't completed voided. Finally, my pattern is pretty much the same during the day.

    • Posted

      Hi dogberry, you are 3 months past your TURP. Can you share whether the TURP has completely resolved the nighttime urination?

    • Posted

      Post-recovery, I have essentially zero BPH symptoms. I noticed an uptick in both frequency and urgency for about five to eight weeks after the procedure. But now I'm peeing like I did in my thirties. As my urologist puts it, "I can pee over my neighbor's fence".

    • Posted

      dogberry, what was your prostate size before the procedure by the way?

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