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enlarged prostate treatment .. TURP

Posted , 12 users are following.

pete49545
pete49545

I am told that I need TURP for my enlarged prostae problem . could any one recommend a good Urologist in Dallas Metroplex area who has good experience in this procedure

1 like, 64 replies

64 Replies

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  • james87669
    james87669 pete49545

    Posted

    I had the TUMT for trans ureathral microwave thermaltherapy. Had that done in January this year. I chose this over TURP because of all the negative feedback. It is an in office proceedure. Although I am not totally satisfied I have improved and not lost any sexual function. At the time I had not heard of nor was advised by my Urologist the Urolift proceedure. Pretty sure I would have gone that route. Good posibility of loosing some important sexual function with the TURP, so proceed with caution.
  • johnsv6
    johnsv6 pete49545

    Posted

    NO, NO, No, NO, No...get the idea?  Read and follow instructions from people who have personal experience. You don't get marital advice from someone who has been divorced...get the info from "real" sources. From everything I've researched, PAE seems the best way to go. Don't let your Urologist bully you around. He's going to be cheated out of an unnecessary surgery. I have an appointment this Monday for an ultrasound. If prostate is 80, my procedure is going to be free. I'm in the states and will be going to UNC-Chapel Hill to get it done. Read, read, read.....JV
    • kenneth1955
      kenneth1955 johnsv6

      Posted

      Thats is right He need to research everything.  I think the doctor only offered the turp is thats is the only one he does.  Get the information before you pick anything to be done to your body.       Because once  they start cutting it's over.  You will never get it back.............Another thing some doctors will tell you is that everything is going to be the same   Ya right  Ken
  • bill80656
    bill80656 pete49545

    Posted

    Don't do it.  Get the PAE.  Prosate Arterial Embolisation.

    Suggest Inova Hospital in Alexandria Virginia. Dr. Bagla. Vascular surgeon.

    Do the research.

    Had a TURP 2.6 years ago. Didn't work. Barbaric medieval torture.

    Had my PAE 5 weeks ago. So easy, no pain, no catherization, no blood, no side affects, no peeing razor blades for 3 months. 

    Urologists usually won't tell you of this new procedure because they can't do it.

     

    • kenneth1955
      kenneth1955 bill80656

      Posted

      Bill yes he need to get all the information to pic.  On here I have hear the men say that there doctors tell them that all will be the same.....Same for the doctor but not the patient   Take care......Ken   
    • johnsv6
      johnsv6 bill80656

      Posted

      Hey Bill, If my plans don't work out and thre's another hoop that I won't be able to jump through, does Medicare or any insurance cover the PAE with Inova?  How much out of pocket? I'm on disability and it could prevent me from any recourse at all money wise.
  • nealpros
    nealpros pete49545

    Posted

    I have a few questions for you fellows who have had a PAE.

    Since a normal prostate has several sexual functions, such as create seminal fluid, ejaculate that fluid, and create some of the wonderful sensations of orgasm; have any of you heard, or do you have any idea why it can function as well or better with LESS blood flow after the PAE, compared to before the procedure? E.G. you have reported better sexual function after the PAE. Doesn't the lowered blood flow injure or partially kill the prostate?

    And, since the prostate is not cut during the PAE, I don't understand why several of you have reported blood in your urine or seminal fluid for a few days after the PAE?

    Thanks,

    Neal

    • bruce19007
      bruce19007 nealpros

      Posted

      Hi Neal,

      Bruce here.  PAE November 21st 2014.  As I understand it, there are cells that die and are reabsorbed and that accounts for the shrinkage.  Those cells are fed by blood vessels and so I assume that blood will leak in various places during the process.

      In my case, the prostate does all the jobs it did before.  I can't say orgasms are necessarily better, but certainly no worse for me.  Also, I believe that the spheres they deposit in the arteries dissolve after a time and normal blood flow is restored.  Gentlemen, please fel free to add to or correct.

    • caringbah
      caringbah nealpros

      Posted

      Hi Nealpros, I'm one of the lucky 30% of PAE patients who report improved sexual function. In paticular I noticed straight away increased penis girth when flaccid and much stronger and thicker erections. Obviously my penis is getting more blood than it did before. I'm only guessing but maybe the blood that would have gone to the prostate is now diverted to the penis. 

      Other sexual functions such as orgasm and semen volume have not been affected. 

      The trick seems to be reducing the blood flow to the prostate by just the right amount. I think that those who were disappointed by their PAE didn't have their blood flow reduced enough. In other words the radiologist didn't place enough pellets in the artery feeding the prostate. 

    • bill80656
      bill80656 nealpros

      Posted

      I'm almost 6 weeks out from my PAE. June 2nd 2015.

      I had no blood in my urine. I had just a little discomfort the first night.

      I did physical labor after 3 days. Big mistake. 

      So far no change in sexual function and everything is working well.

      Very happy so far. I have had urination issues for 30 plus years. Now I am so relieved that I pee so much better. I get up at night only once now, I can drive for a few hrs without having to pee wherever there is a bush on the side of the road. I don't know the answers to your other questions.

      Bill

    • nealpros
      nealpros bill80656

      Posted

      Hi Bill,

      What happened after you did the physical labor, and how long did those problems last?

      Neal

    • bill80656
      bill80656 nealpros

      Posted

      Hi Neal,

        Well you see I own a campground and I was still in the process of getting ready for the season. I was lifting, pushing, pulling, stretching etc. I thought that I could get away with it and I was doing half of what I normally do.

      About 4 days after the procedure I woke up to find that my leg from the knee up to the incision on the inside of the leg was solid black and blue.

      Apparently I had caused a small leak in the artery whereby the blood flowed down just under the skin creating the black and blue. There was a small amount of pain with it. I think that it took about a week to clear up. I guess arteries can heal over themselves. There is still a small amount of soreness when I rub in the area. 

      In the end it all has turned out pretty well.

      Compared to the TURP 2 years ago the PAE was nothing. 

          It is interesting in hind sight how much the urgency and frequency issues negatively impacted my life, my attitude and really my whole being. I'm realizing it now more and more everyday as my ability to urinate improves so has the quality of life.

         Thank goodness for the PAE.

      (I started to pee better after the first week or so which they told me was very unusual.)

       

    • pete49545
      pete49545 bill80656

      Posted

      I am considering TURP vs. PVP Vs. PAE .. what would you recommend?
    • caringbah
      caringbah pete49545

      Posted

      After all that's been written here about TURP I am very surprised that you are even considering it. If you want to be impotent and incontinent go right ahead. 
    • nealpros
      nealpros bill80656

      Posted

      Thanks for the report. I'll pay heed to your advice. I'm trying to hold off as long as possible in hopes that the doctors will get more experience with the procedure.

      Neal

    • bruce19007
      bruce19007 bill80656

      Posted

      The black and blue is very common.  I had the same thing.  the black and blue spread the first 3 dyas and then reversed and cleared up in about a week and a half. I also had a soreness at the incision site for a few weeks, but didn't notice it unless I pushed on it.
    • johnsv6
      johnsv6 pete49545

      Posted

      Not to be rude, but obviously you haven't read the forum. Turps is for chimpanzees. PAE is the way to go.
    • derek76
      derek76 johnsv6

      Posted

      Patients like urlogists have their own favourites.

      Sadly newcomers here have to sift through the wheat from the chaff. 

      It a newcomer just searches this site he will get up to date good medical advice on all conditions.

      https://patient.info/health/prostate-gland-enlargement.

      Moneyed or insured Americans have a wide choice of treatments but poor UK relations who this site is set up for mostly have to rely on what the NHS does in their area. 

       

    • bill80656
      bill80656 nealpros

      Posted

      Neal,

        There seems to be a hand full of Doc's in the US that do it. Bagla has done over 200. Seems like enough experience to me.

      My quality of life has improved a lot. In hind site just beginning to realize how aweful it is to have urination issues. We don't really realize how bad it is while we have it. There where times that I had to stop to pee in my truck every 15 minutes for several hours. Now that is miserable. Getting up to pee 5 times in the night, thereby not really having a sound sleep.

      How bad is that???

      Have the PAE and get back your life.

    • nealpros
      nealpros bill80656

      Posted

      Bill, you make an interesting point. I had ED problems, got a good penile implant and couldn't be happier with it. It solved a problem I had off and on for 50 years. I live in central Florida, and will see if I can find someone there with as much experience as Dr.Bagla (Anyone have any recommendations? ). I had my PI surgery in NYC. With Medicare and Tricare, the surgery was free, but the flight there and back, and the hotel cost nearly $3,000 for my wife and myself.

      Neal

      PS Thanks to you others who have provided input to my request for information.

    • nealpros
      nealpros

      Posted

      Bill, please give me contact information for Dr. Bala again.

      Thanks ,

      Neal

    • caringbah
      caringbah nealpros

      Posted

      Don't be too worried about lack of experience. I was  the third person in Australia to have a PAE and I couldn't be happier. 

      As my interventional radiologist explained to me, IRs are trained to embolise any organ. They embolise kidneys, uterus, rogue arterys etc. The prostate is just another organ. If they can find the artery leafing to your prostate they can embolise it. If it doesn't work you can always have the next best thing...in my opinion a Holep. 

      I would be enquiring on how much embolisation experience the IR has had. Having said that I don't think I'd like to be first but I was happy to third. 

      My thinking was to go with the best procedure in terms of outcomes first. If it didn't work then go with second best. I hit the jackpot first time.

      No incontinence, no impotence, no retrograde ejaculation. 

      Neal, I don't have any axe to grind, I don't receive a referral fee...I just hate to see someone making a terrible mistake. 

    • nealpros
      nealpros derek76

      Posted

      This website has some useful information. It also soft pedals the side effects of the medications, and the TURP, and doesn't discuss PAE at all. People would be well advised to read all of the posts in this (and other ) blogs before making decisions regarding their treatment.

      Neal

    • nealpros
      nealpros

      Posted

      I was replying to the link with information on the prostate, not the comment above. Apparently the system misrouted my comment.

      Neal

    • kenneth1955
      kenneth1955 nealpros

      Posted

      Neal you have to look at all the procedures and pic the one you think is best for you.  What may work for one may not work for another.  Sometimes the doctors will tell you only one thing because that is the procedure they like to do.  Pae is a good procedure but is it the right one for you.  Chuck on here had it done last year and cost him $10.000 It did not work.  He then had a urolift He is much better with that.  Just get the information on anything you pic.  Read all you can and also look at the side effects.  They pic wich one to do.  Be prepared for the out come so your not surprised.  Take care  Ken  
    • nealpros
      nealpros kenneth1955

      Posted

      It seems like it is a crap shoot. The outcome seems to depend mostly on the skill and experience of the physician. I'm continuing to do research on procedures and doctors, and looking for input on both. Thanks,

      Neal

    • kenneth1955
      kenneth1955 nealpros

      Posted

      No Problem.  The outcome is to help you not to give you other problems. Try if you can not to have anything done that cuts away at the prostate. Some doctors feel that after 60 a man is not interested in sex. So they just cut away.  When a man hit 60 he can enjoy all he can.  They tell you that sex will be the same but  I done know if you ever had a dry orgasm. It''s not the same.  Take care
    • derek76
      derek76 nealpros

      Posted

      I'm not sure how available PAE is here. As it and Urolift are new we are lacking in long term results.
    • derek76
      derek76 nealpros

      Posted

      My PVP was only the eighth done by my Uro and I had complete confidence in him.

      My Holmium laser one had done hundreds of that procedure.

    • caringbah
      caringbah nealpros

      Posted

      Neal, I think you'll find that's true for any surgery. There is a wealth of information here from guys who have had successfull procedures. It's not like you're going blind. 
    • nealpros
      nealpros caringbah

      Posted

      Yes, I agree. I really appreciate the input, and information, particularly from those who have been there, and are sharing their knowledge.

      What I am also doing is waiting, if I can, until I have enough "votes" for a doctor that I can reasonably reach. I think that a report from those who have been there is one of the best ways to choose a doctor. I had a complication on my penile implant. It necessitated a second surgery to really "straighten it out, so I am a little gun shy.

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