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Facing "Prostate Shaving"

Posted , 9 users are following.

ianC
ianC

First off, I would like to thank all those whose contributions I've been reading (mainly those responding to graham30431). I really appreciate all that info on possible alternatives, with personal experiences as well as the pros and cons.

My case is a little different. After initially being diagnosed with stage 4 terminal bladder cancer and told I only had weeks to live, plus there was nothing they could do for me, I became a pro-active patient (doctors advise, I decide). All that was nearly 7 years ago.

I have been on Tamsolusin on and off (definately on in the last year) to help peeing.

In the last year, my blood pressure has risen to dangerous levels. Hypertension pills have helped somewhat, and by experimenting I've got to a good combination with little swelling and other side-effects. But then my remaining kidney started failing.

Investigating this a couple of weeks ago, it was found that my retention (no-one mentioned PVR) had worsened from an earlier 'normal' of 500-600mL to 1.2L and this was thought to have caused the kidney problems. 

I'm now catheterised for 4 weeks (half-way through now), and both my blood pressure and kidney function tests are showing an improvement.

The last thing the urologist said was that they'd probably be considering prostate shaving. Hence my coming to this forum and reading up on the alternatives (Urolift sounds an attractive option if I'm suitable). Whilst I understand that TURP is both the gold-standard and generally OK, the stories here have underlined the serious risk of bad side-effects. So I'll see if I'm eligable for some of the alternatives (not just Urolift, but PAE and WHY).

I'll update when I've seen the urologist next.

1 like, 35 replies

35 Replies

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  • derek76
    derek76 ianC

    Posted

    To me prostate shaving is TURP by another name. Same tools but perhaps less tissue removed.

    Has Alfusozin been mentioned as an alternative to Tamsulosin?

    • mark357
      mark357 derek76

      Posted

      I know I have more tests to come, but I don't know what they are as this is the first time in relation to an enlarged prostate.

      All that I had which picked up the problem was when I had my test in relation to bladder cancer as I am in remission and the camera picked up the prostate. Also with my output was like a dribble.

      But I send everyone my appreciation for your help in this matter.

    • ianC
      ianC derek76

      Posted

      Thanks for that quick pickup derek. Yes, I realised that the shaving was an alternative for TURP. And that there may be problems if I had that - hence my finding this site for experienced info and possible alternatives.

      As to Alfusozin, I've never heard of it. I'll chase that up. Thanks.

    • derek76
      derek76 ianC

      Posted

      If you ever need cataract surgery Alfusozin does not create problems for the surgeon as Tamsulosin and another one does.
    • ianC
      ianC derek76

      Posted

      Wow! Thanks for that tip. No that my eyesight seems to be a problem right now (I did have retinal tear due to high blood pressure, but that's healed). I'll ask my GP about this alternative.
  • bob120
    bob120 ianC

    Posted

    Another alternative is self cathing every 6 or 8 hours around the clock (depending on how much is voided per day). My guess is A relative of mine lost bladder elasticity due to a very high PVR. He had a turp, but soon was in retention again due to lack of elasticity.  He caths every 6 hours. After my GL turp, my uro said a PVR up to 250 ml was OK. You might also check for bladder stones. I had high uric acid to begin with (just one Guiness stout caused a gout attack) and my BP meds Micardis HCT caused increased uric acid. After one year on the Micardis I had bladder stones for the first time. Another consideration is the bladder neck. 

    18 months after my GL turp, I needed a bladder neck resection and bladder stones removal.

    • derek76
      derek76 bob120

      Posted

      My GL PVP was bladder neck sparing as that is the area that can cause incontinence. My flow was never good as I expected but as urgency, frequency and retention had gone I was not overly concerned. Two others I met when at the six month follow up said the same.

      Flow after the Thulium Laser procedure is variable. The surgeon offered to do a cystoscopy to see if anything needed 'adjustment' But I prefer to leave well alone.  

  • Dudley71081
    Dudley71081 ianC

    Posted

    Dudley >  IanC

    Hello Ian.  Prostate shaving is also referred to as a Mini-TURP.  I had this procedure in late January together with a BNI ( bladder neck incision ) without which, I could not have received EBRT for PC which then commenced on 31/3;  ( because my pre- radiotherapy treatment flow, was too poor ).

    Somewhat to my surprise, I was de-catheterised the day after the op and my stay in Hospital was only about 30 hrs all up. I pee-ed my pants badly as I walked  out but, hey, who isn't happy to be leaving and I sure wasn't turning back !

    Pelvic floor exercises are I believe absolutely vital in helping to overcome initial incontinence.

    I really worked at this, holding contraction of the muscles well beyond the suggested 15 seconds each repetiton. In fact, I held each contraction for as long as I possibly could, maybe 45 -60 each secs and really scrunching things up down there. Doing 3 or 4 contractions each session, perhaps two -hourly. The result of that was in my case amazing and incontinence stopped at three weeks.

    As with any operation there are things that could be, by degrees from one patient to the next, less than satisfactory, but the potential for this to be an extremely effective operation is very high.  And the relief obtained by being able to ( hopefully ) void satisfactorily,  is a real psychological tonic.

    Good on you Ian. Go well. You sound like a real fighter !

    Regards 

    Dudley

     

    • ianC
      ianC Dudley71081

      Posted

      Thanks dudley. I hadn't been aware of that aspect. Clearly something for me to do if I go down that route. At the moment I do't know if I need anything other than just the shaving; with luck the Urolift.
    • derek76
      derek76 Dudley71081

      Posted

      When I was in to have my PVP a man who had prostate cancer was in to have his prostate shaved to enable him to Pee prior to his cancer treatment starting. I can't the remember the treatment he was going to have but I would have thought that the procedure might have released cancer cells.
  • Dudley71081
    Dudley71081 ianC

    Posted

    Hello Derek

    If the gentleman you refer to needed a minTURP before receiving treatment for PC,  then he was being prepared for either Brachytherapy or EBRT.

    A flow test is conducted as part of our assessment and if we 'fail' it,  then we are obliged to have the prostate shaved/TURP,  or they will not administer the radiotherapy. 

    This is because the RT causes a considerable amount of local swelling/ inflammation to both the urethra and the bowel which to those affected can and often does endure lengthily, sometimes permanently. 

    As to the ' release ' of cancer cells...it's the natural thought that occurs and yes, I dare say we all ask that question prior to giving our consent. 

    I was told there is no evidence for it, but how the incidence of it can be quantified outside of the natural progression of the disease itself, would seem impossible to determine.

    In any event, those of us ( Public Patients that is ) going down that path really have no choice unless the Hospital can offer us an alternative means of permanently dilating the urethra;  which in my case at least,  was not available.

    Incidentally, do you mind me asking if you actually have Prostate Cancer  ( whether it is in remission or not ) ?  I only ask this because the way you have structured your response to me, tends to suggest that you have not been down that road.  Or otherwise, you would already know the answer to the doubt you raise.

    Regards

    Dudley

    • derek76
      derek76 Dudley71081

      Posted

      Hi,

         Thank you for your detailed response. Glad to say no PC just a prostate that grew rather rapidly for a second time after having been Zapped. 

      Many having a prostate biopsy (I had two) were concerned about the possible release of cancer cells during it.

      Did you ever use the NG's sci.med.prostate.bph and sci.med.prostate.cancer ? In pre forum days they had hundreds of regular posters.

      Presumably you are in America. How does the system treat Public Patients?

      The father of a friend in America was rather badly treated in Veteran's Hospitals.

      The only American hospital we saw the inside of was Cook County in Chicago on one of ur trips to America. We thought that we would like to see where some of ER was filmed and wandered in to look in vain for anything familiar. A passing doctor as if he could help us and was kind enough to give us a brief tour.

      I thought at the time that the other patient would have been better to have had laser surgery than a 'shave' 

    • derek76
      derek76 Dudley71081

      Posted

      I forgot to say that our NHS seems rather loath to do prostate biopsies nowadays. When my BPH was diagnosed in early 1995 my PSA was 5.1 and they did a biopsy. They did another about two years later.

      As my prostate grew my PSA went up to 9.6. As I did not want a TURP I did not see another urologist until 2004 when I got my GP to refer me back to my local hospital for onward referral to one of the few hospitals trying out laser surgery. I felt that my GP was probably right in saying 'Big prostate, high PSA'

      Unlike others my PSA only went down to 5.0 after my PVP. It has not been checked since having the Thulium Laser surgery last year. It would seem not to matter as the debris sent to histology found no traces of cancer.    

    • bob120
      bob120 derek76

      Posted

      Hi Derek, 

      If you are over 65 Medicare will pay most of your medical costs. If you are under 65 you need private health insurance. Either of these options get you the same treatment as paying cash. If you are very poor you qualify for Medicaid, which is like Medicare for poor people under 65.

      I don't know what the numbers are now, but when Obamacare was passed into law, there were more than 30 million Americans with no health care.

  • peter06554
    peter06554 ianC

    Posted

    I recently 6 weeks ago went into hospital for a stone removal from my bladder and Turps if required. I had been passing blood for at least two weeks before I was admitted. I arrived at the day centre at 1pm and went down at 2pm. I came round at 4-30 to be told they had a problem. no bed? After five hours they put me back in the day centre and said they had removed the stone and shaved the prostrate. obviously i had a catheterThere were four of us including a lady and they had to call in night staff as the ward closes at 7pm.

    The next day still bleeding they removed the catheta and sent me home. Not a nice experience but i can say that i have fully recovered no bleeding and passing water fine. Some times these things are sent to try us but if the out come is good its worth it.

    • ianC
      ianC peter06554

      Posted

      Thanks for that detailed personal example Peter. It does give me some confidence that I'll probably be OK if I have to go down the TURP route.
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