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Going for urologist consultation on 100 cc enlarged prostate

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chris04161
chris04161

I first noticed difficulty urinating 14 years ago when I was 37. At 50, two years ago, DRE suggested abnormality. DRE last year -the same thing:- '

"it does not feel right" Both years PSA is 4.8. GP referred to urologist at age 51 who prescribed Tamsulosin. To the end, I strain to urinate and carry pee bottle with me in the car and in my office. Last month cystoscopy reveals bladder stone and BPH. Prostate biopsy ultrasound measures my prostate to be 103 cc in volume. Ct scan ob abdomen/kidneys was normal except for large prostate. I was close to renal backup after these procedures so I am using a Foley Catheter. The 30 year 'veteran' urologist suggested TURP while tomorrow the Gleason score will be returned. Each man must decide carefully own his own but your comments are appreciated.

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  • timothy81571
    timothy81571 chris04161

    Posted

    Your probably not a candidate for Rezum (too large) or Urolift (total retention), so maybe look at Holep. Another person just posted their Holep experience at your age.

  • Marky_Mark
    Marky_Mark chris04161

    Posted

    I too strain like you to urinate. It is awful. It used to be around 15-25 minutes, but lately about 1/2 hour and more sometime. I was going to have a TURP Operation, but the URO asked me if I really wanted it the morning of the surgury. I told him my urinations were getting better, some at around 15 minutes. He said it was better to not have the surgery, because 15 minutes wasn't bad and I could live with that. I have been struggling and consumed by time it takes to take care of the urinations since then and it really affects my life. The URO says my prostrate isn 't bad enough to operate on. My stream is o.k., he says. I am going in to tell him about the awful long urinations. In two weeks I get evaluated by another URO group that was referred by the first URO. It has taken a long time. Too long....

    • dennis47445
      dennis47445 Marky_Mark

      Posted

      Mark, I used to have the same problems as you. What I found to be helpful, is doing CIC. After three surgeries over a period of 14 years, the best thing for me was self catheterization. I feel great and really comfortable after I self cath. Yesterday, the time between self catherization was 7 hours. Usually, it's around 3 to 4 hours.

      Ask your uro, if you can try self catherization for awhile. It's the best feeling when you have a totally empty bladder.

      I used to be able to do it in 3 seconds, from inserting the catheter, till it reached the bladder. I stopped doing that, because it was foolish of me to try and see how fast I could do it. The last time, I tried going for speed, the catheter must have scraped the inside of the bladder, and blood in the urine, was the result. Now, I go really slow, so as not to injure anything. What was once 3 seconds, is now around a minute.

      I suggest you give it a try. Instead of you going to urinate, every 15 minutes, it will be hours in between toilet trips!

    • Marky_Mark
      Marky_Mark dennis47445

      Posted

      Thank-you very much Dennis. I will ask my URO. The only thing is that I'm on fiber tablets and that may interfere with the self cathing. Probably wouldn't need them if I cath though. I would love to have time to live life again.

  • derek76
    derek76 chris04161

    Edited

    I refused a TURP as far back as 1995 when I was 60 due to it being a form of butchery with unwelcome outcomes. I waited for GL PVP to come along and that had a good outcome and a quick recovery from it and no RE. (75 grm prostate). It regrew and I then had Thulium/Holmium that is similar to HoLep in 2013 and have had no later problems. I had RE after that but that had already started from taking Tamsulosin and I was 79 by then.

  • barney34567
    barney34567 chris04161

    Posted

    In relation to straining to pee, some guys have a burning sensation when peeing.

    I found URAL sachets mixed with water to relieve a lot of discomfort

    while peeing.

  • oldbuzzard
    oldbuzzard chris04161

    Posted

    You've been given a lot of really bad info - from your doc and from this forum. The facts:

    1. You can get Rezum with a prostate of your size. The recovery is longer (more tissue to ablate) but the results are comparably good.
    2. They shouldn't be doing a Gleason score unless/until they confirm that you have prostate cancer. A PSA of 4.8 doesn't mean that you do. An MRI, or if your URO is in the dark ages a needle biopsy is necessary to confirm cancer. And 95% of all prostate cancers never cause any problems. So don't even consider treating cancer unless you confirm you have it. If you do, then look at the Gleason scores and make an informed decision.
    3. DO NOT have a TURP. Its the oldest and most invasive treatment for BPH and as a result, should only be a last resort. In order of preference should be 1) Rezum - very good success profile, very low chance of permanent side effects (5-10% for RE, almost 0 for anything else) and doesn't preclude any other procedure. 2) Greenlight. More invasive than Rezum, but less than a full blown surgery - 50/50 chance of RE and recovery can be messy for a month, but the results are good in experienced hands. DO NOT let anyone who hasn't done hundreds of these do this. In the wrong hands serious damage can be done. In the right hands the results are generally good. 3) Holep - a full blown surgery that will leave you with a very high chance of RE, but if the others fail will likely work well. Less invasive and shorter recovery that TURP.

      Good luck and I agree that CIC is the way to go until you decide to do something else. It will prevent bladder damage and allow a normal life. Some are fine doing it indefinitely and that is an option. If you want to lose the catheter, find someone who does Rezum IMO.

    • hank1953
      hank1953 oldbuzzard

      Posted

      Holep is NOT a full blown surgery. It's considered a minimally invasive procedure, with very high success rate, less bleeding and shorter recovery time than most.

    • oldbuzzard
      oldbuzzard hank1953

      Posted

      If you need general anesthesia, it's a full blown surgery.

    • hank1953
      hank1953 oldbuzzard

      Posted

      For holep, "... Intradural anesthesia was the most common technique...", not general anesthesia.

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