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Greenlight or TURP for BPH?

Posted , 16 users are following.

Mrchuck2000
Mrchuck2000

I have BPH, symptoms being urinary retention and recurrent UTIs. My urologist recommends surgery, and has ruled out a Urolift due to my having an enlarged median lobe. That leaves me with a choice between TURP and GreenLight laser, and he’s really pushing TURP. From everything I’m reading however, the Greenlight procedure seems just as effective, and has lower risk of side effects and a much shorter recovery time. Above all, I’m seriously concerned about sexual side effects above all. I’m 57 years old, and I’m not ready to “cash in my chips” just yet. I already have ED issues, and the thought of further sexual diminishment is leaving me quite depressed. Is my doc pushing TURP because he’s more experienced with it?  Are there other options? I’m wondering if a second opinion is advised. Any feedback from guys who have been through this?

0 likes, 52 replies

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  • kenneth1955
    kenneth1955 Mrchuck2000

    Posted

    Chuck  I would not give up on your sex life.  GL and Turp would get rid of it more Turp they GL but it take sometimes up to a year to get anything back.  This doctor he he the one that is telling you that Urolift will not work.  I would see a doctor that does Urolift for a second opinion.  There have been very good results on median lopes in the trails.  They just pull it to one side.  I did not have a median lobe issue but my prostate was closed and the size of a large lemon.  Been over 3 years and still wide open.  No side effects at all.  With GL and Turp you will get sexual problems and retro is a given.  Good luck  Ken   
    • emil54651
      emil54651 kenneth1955

      Posted

      Ken, you are actually not right on all your assertions. I had median lobe, two urologists said Urolift was not an option. I decided for GL and Vaporization. Results are good for me. Can pee again and forward ejaculation. Urologist warned  that 30% chance of retro exists. I guess I’m one of the lucky 70%.
    • kenneth1955
      kenneth1955 emil54651

      Posted

      Yes you are one of the lucky ones.  And that is good for you.  But My urologist told me that TURP is a last resort.  He and his partner do very few.  And I don't think Chuck is there yet not at 57.  With GL it's hit and miss.  It all depends on how good your surgeon is.  And 30% is not good odds.  They have been working on trials and have had very good results on pulling the median lobe to one side.  My urologist has done some that have worked very well.  Because the patient did not want any cutting done and did not want and side effects.  He did what the patient wanted  Even in the UK the doctors tell there patient to start with the less evasive procedure first.  That may be all he needs. And it's not up to us.  We will not have to live with what even he decides.  Even his doctor does not have to live with the out come.  Chuck will have to deal with the out come of whatever he pic's .  Ken       

    • stan98754
      stan98754 kenneth1955

      Posted

      Sorry Ken  ,  some  median lobes is impossible to  treat with Urolift ,  that is my case - IPP - Intravesical Protrusion of Prostate to bladder.  Its not only point of view of Drs,  but simply seen from  anatomy.  I can send  MR scan  . Stan   
    • kenneth1955
      kenneth1955 stan98754

      Posted

      Stan  I just don't want you to do anything that will mess up your sex life.  I don't know if you have ever had a dry orgasm.  They suck.  And also if you can have a orgasm.  Sometimes the feeling goes down to a 1/3 of what it was.  There have been men that after there procedure they give up on sex all together because the feeling is not there anymore.    At 62  I would never do anything that would stop my orgasm or my ejaculation.  I was 58 when I had my Urolift.  If you get a good doctor they can pull it out of the bladder and clip it to one side. Anything is possible.  Some doctors don't care enough to listen to the patients concerns..  And most doctor at cut happy.  Also a doctor can only tell you what he thinks may work but after you have it cut out it's to late.  But it is up to you.  You will have to deal with it.  The doctor will just move on to the next patient.  Good luck to you and may god help help you do the right thing...Ken

    • stan98754
      stan98754 kenneth1955

      Posted

      HI Ken  , Im  63,  never  RE  . Flying to  Houston  from Vienna  for FLA  procedure  in  2 weeks,  trusting in my return to life.  Best Wishes, Stan   
    • kenneth1955
      kenneth1955 stan98754

      Posted

      Good luck to you.  Doctor K.  Is a very good doctor and he has done very good for alot of the men on here I wish you well.  Ken 
  • Mrchuck2000
    Mrchuck2000

    Posted

    To ALL of you, thank you so much for your input! All of the respondents have really opened my eyes to the possibilities for BPH that I have not even been told about by my urologist. What I’m first going to do is get a second opinion, and possibly a third. TURP IS OFF MY LIST, also GL is only as last resort. And at the top of my list of procedures is REZUM (though I will discuss whether Urolift is possible at all with my median lobe). After that, I put HoLEP and FLA, and I’ll ask about PAE, despite doubts about my large median lobe. I have contacted two large urology groups here in Los Angeles, and have an appointment with one already scheduled for end of the month. 

    The awkward thing I must do now is meet with my current urologist and tell him my plans. He’s been great to deal with about a low-T issue, and I’ve felt like I could easily talk to him about intimate subjects, but I’m afraid he could take offense that I’m looking for other opinions. I’m not great with diplomacy, so I know I might cause him to feel offended. Bottom line, though, this is concerning an essential part of my identity as a man. Hey, I’d much rather lose an arm that damage or cripple this part of me! It’s that important to my sense of who I am as a man.

    I’m so grateful to all the men who have commented. A patient can’t do what a doctor does, but patients know things a doctor can never know. I’ll keep y’all posted!

    Chuck

    • stan98754
      stan98754 Mrchuck2000

      Posted

      Hi Chuck.  be  carefull , pls see this comment just received on other forum discussion :

       .............................................................................

      ?6 kenneth1955  Jag1052about 4 hours agoGood afternoon everyone.  I sent my urologist a e-mail about Rezum because of a man on here that I have been talking to for 2 month's Trying to help him.  He had the Rezum done 7 month's ago and has no improvement.  The only thing he got out of it was retro and at 52 he is not happy.  He was going to see a new urologist today to see if they can help him pee and if there was a way to fix the retro.  I did get a e-mail from him a few minutes ago.  I am going to write it just the way it wrote it to me.  My doctor said that a friend of his had the Rezum procedure. ( He said that he is skeptical of the Technology ) He did not do it.  He's friend had it done and it did not work and it caused him horrible bladder contracture.  To fix the problem he had to have a Turp.  My urologist partner did it for him and he assist.  He said that it is very hard to try to fix something when you are frying the prostate and destorying the ducts.  He said that the only way you can try to fix it is to resect the ducts to a place that was not affected but most of the time he said you have to resect the bladder neck and you will end up with retro anyway.   So whats done is done.  So when you pick a procedure be ready for anything  Take care  Ken    .

      ...............................

      REZUM can be effective method,  but the bids are located randomly  and can damage fatal structures.  Thats why I selected  FLA .   Even I made   Excell table of many patients data  , where is evaluation of    methods.  From this analysis  the FLA is winner.  I can send it to anybody , just PM me.   Stan    

    • derek76
      derek76 stan98754

      Posted

      Laser is precise but can that be said for a blast of steam ?
    • stan98754
      stan98754 derek76

      Posted

      you are right  ,  laser is working with accuracy of 1 mm . During FLA ls all procedure  under visual  control  of IR  to avoid  damage of fatal structures,  -  urethra,  bladder neck ,  sphincters,  ejaculating ducts, nerves, prostate muscles.  REZUM works but  with random  bits,  - the risk is much higher.  Stan   
    • kenneth1955
      kenneth1955 stan98754

      Posted

      Stan  I did send a PM to Chuck So he knows what is going on.  It's a gamble what ever you pick.  My urologist is very straight forward.  He try's to do what is best for the patient but he also is aware of there concerns.  That is why information is the key  Ken  

  • dennis47445
    dennis47445 Mrchuck2000

    Posted

    Mr. Chuck, I've done both, greenlight and turp.  Of the two, the turp is the better one.  it really cleans out the passageway...it did for me.  Greenlight, was not as effective.  If I could turn the clock back, I would do neither. Instead, I would do CIC. With CIC, you will empty your bladder completely and no concerns about retro and error from surgery, that could be a lifetime problem, according to some on this forum.  Your uro, will probably talk you out of doing CIC, and in my opinion, it's because the money is not that great, as compared to surgery.  Good luck, with your decision.

    • stan98754
      stan98754 dennis47445

      Posted

      Im providing  CIC  more then  1 year  now twice a day   with PVR  200-350 ml .  Just  6 months ago  it was ones a day and  PVR 100-150 ml. So the situation is worsening  and CIC is not  longterm solution just  temporary one within your final decision.  My  is FLA.  ( big median lobe with IPP , there are all other methods  problematic )  I did PAE ,poor results. Stan
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