Green Light Laser and TURis

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I had a urology appointment at my local hospital this week. This is a hospital that five years ago told me that the reason my prostate had regrown was because I previously had Green Light PVP rather than TURP .

The urology nurse told me that since recent NICE recommendations

  they now offer patients TURis or Green Light Laser rather than the standard TURP.

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16 Replies

  • Posted

    Hi Derek

    That is great news, I take it that this is a UK hospital offering Laser TURP or TURis on NHS. These procedures appear to have less side effects ,less time in hospital and for those like me with thin blood (Have been taking aspirins for over 10 years due to a temporary stroke in 2003). I wish I knew about them 6 months ago. All the very best Peter

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    • Posted

      I was taking aspirin when when I had Gren Light Laser in 2005 and they said there was no need to stop it.

      At the time of my next laser surgery in 2013 I was taking Warfarin and stopped it for about four days though again they said that there was no need to.

      Blood after laser surgery that seals the blood vessels as it it is done puzzled me. The urology nurse said that the blood mostly comes from the urethra that sustains a lot of trauma from the instruments and absorbs blood and swells up like a sponge.  

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  • Posted

    Thanks for your help im reading through it atm. Its hard because i have swolen painful right testicle and also pain from the right vas diferance have you ever experianced this? Im trying to work out if the problem leads from my prostate as 4 loads of antibiotics havent made any improvement. Its starting to get me down
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    • Posted

      Snap:-)

      I had slight pain in my left testicle after my laser procedure in May 2013. I did not think too much about it at the time. It later worsened when I had a prostate infection due to the catheter being left in too long. Since then I have had other UTI's and bouts of prostatitis that seemed to account for the testicular and other pains.

      The last prostatitis got better but the testicular pain increased greatly and I went back to my GP after Christmas. He did an examination and checked my urine sample said it was an infection causing  Epididymitis and prescribed Cipro. When it was little better after two weeks I phoned him and he thought that I may have had two infections and only one had responded so he prescribed another.

      My next urine sample was clear but as my urine flow was mainly very slow he referred me back to urology.

      I had the appointment on Thursday. My flow test was a disaster that produced a dribbling 87mls but only 130mls retention despite having drank a vast amount of liquid in the preceding two and a half hours.

      The urology nurse checked my testicle and found no swelling but it is still painful. She said that is often an after effect of laser surgery. She did a DRE and said that there  has been some re-growth in my prostate. The reduced flow could be due to that, scar tissue or a stricture. She has arranged for me to have a cystoscopy in a couple of weeks.

      After my last surgery they suggest that I should take Avodart to prevent future re-growth. I asked if at my age it was likely to re-grow enough in my lifetime to cause future problems. He glanced at my age (79) on his notes and said pehaps not:-)

        

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    • Posted

      Very very helpfull derek the first i have had some detailed explanation so far the interned explaness nothing thanks i beleavee this os the exact same thing i have got exept doctor seems antibiotics r best (no worked) thanks for your time 👍

      Stuart

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    • Posted

      Epididimytis like prostatitis seems to be a little understood condition that can linger for years. I think but have not yet inquired that it may be partly caused by retro causing a failure to ejaculate as this condition can afftect Guys who have had a vasectomy.

      Try googling this:

      Epididymitis lingering or something else?

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  • Posted

    The main problem with TURis or Greenlight Laser is the high frequency of retrograde ejaculation.  The medical community glosses over this as a minor side effect of the procedure, but this can be emotionally harmful to a man.  For no sexual side-effects, I still rate Prostatic Artery Embolization as the best.  It is not done through the transurethral route.
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    • Posted

      Amongst the many hundreds of posters on the sci med prostate bph News Group since Green light started well over ten years ago not many complain of retro. If the surgeon does a bladder neck sparing version of Green Light  it should not happen.

      The gland shrinkage after PAE does not seem to be very great. Can problem lobes be targetted?

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    • Posted

      On Greenlight laser, I called the company who makes it.  From their clinical trials, there is a 33% chance of retrograde ejaculation.  For my urologist, it is around 50%.  I asked the company agent why such a high RE.  She said it wasn't the doctor, but the procedure itself.  Some people have been pleased with it.  Others wish they never had it done.   PAE has a nice upside with no sexual dysfunction compiications.  It either works or doesn't work.  At least there is no damage left.  The movement is toward procedures that preserve sexual function.  Like Uroflit. Nymox-1207 is an injectable that didn't do well in phase 3 of clinical trials unfortunately.  Another one, PRX302 injectable is in clinical trials.  At some point, we will have an injectable given in the doctor's office.  If we can just buy some time without harming ourselves in the process

      I emailed Dr. Martin Pisco in Portugal recently about any problems with prominent median lobes.  I've been in contact with him about having PAE done there depending on costs.  He is very honest about having a 15% non-response rate, reasons unknown to him.  You can check his website.  Just Google Professor Martin Pisco.

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    • Posted

      With tissue removal it obviously depends on the area where growth is and if they are working in an area that may damage sexual function. I've been looking at and hearing about procedures and drugs since 1994 and new ones come and go.

      With TURP and Green Light many people get away with one procedure but it seems to be down to the shape and size of the gland.Perhaps if I had chanced the TURP offered when my prostate was only 35grms it might not have grown again... who knows.

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    • Posted

      I've read that correction around the median lobe has more of a chance of retrograde ejaculation.  We can compare notes on this.  A transurethral procedure is traumatic to the urethra.  Sometimes there is urethral stricture after the procedure.  The PAE is still attractive to me because it is using an alternative route to shrinkage, blood supply. I was reading Dr. Pisco's diary earlier on his website and he gets some pretty severe cases from around the world.  

      Mayo Clinic doctors were there on January 15. 

      We have to make some tough choices.  As Hippocrates said, "First, do not harm."  

      There are things that have efficacy from alternative medicine.  Stinging nettles root extract, pygeum, saw palmetto (works better in mild to moderate cases), graminex (pollen extract), et al.  These are things that can be used to keep the prostate healthy and slow down growth.  

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    • Posted

      I found that Saw Palmetto helped with my flow and urgency. It made no difference to the continued growth of my prostate over the nine years I was taking it in tincture form. UK urologists tend to be against anything hertbal but some German urologists prescribe it.

      Some who took nettle root extract found that they were going to the toilet every half hour. Some people have praised beta sitosterol for its help.  

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    • Posted

      Saw palmetto has conflicting studies.  It tends to work better for mild to moderate cases.   I read one study where it did have 6% reduction in prostate size as compared to Proscar which had 17% if my memory serves me correctly. The combination of pygeum and saw palmetto work better.  Beta sitosterol seems to work.  I have heard of people using 1000 mg to 3000 mg to get results which is beyond clinical studies.  I think there is something to Graminex for better flow and for some shrinkage maybe caused by inflammation.  I use a supplement that has 11 things in it at clinical dosages.  If I post the company and product name, the moderator will refuse it.  

      Before modern medicine, this was all people had to remedy their ills. Could you imagine someone with BPH problems a century ot two ago?Out of desparation to survive, they founds things in their environment to help with their maladies.  

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    • Posted

      You know about the Victorian Gentlemen who went around with a catheter wound round the inside of their top hats. Most died of an infection within months.
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