GreenLight Vs Urolift

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Hi

I live in Toronto, Canada. I have been suffering with BPH for the past five years. I am 54 years old with no children and don't expect to have children. I am faced with two options. Take the greenlight surgery which is completely free and is paid by the government health insurance. The other option is to do the Urolift, but it will cost me $10000 which is not covered by insurance and has to come out of my own pocket. $10000 is a lot of money for me. I am not sure how long the urolift will last and if my prosate will keep on growing even with the urolift in place.I really don't know what to do. Hoping that you'll can give me some suggestions.

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  • Posted

    Hi Daniel,

    Difficult choice. Sorry to read that. In the end, of course, only you can decide.

    My view is that it would be worth shelling out for the UroLift. Three reasons to my knowledge:

    1: there is less chance of erectile disfunction;

    2: of lengthy (tho' not painful, if my experience is anything to go by) healing (leukocytes and blood in the urine) - mine is still happening after 3 months of HoLEP surgery (a supposed improved version of green light surgery); and

    no external ejactulant (seems the latter part of the urethra is lost, resulting in the ejcaulate gong straight into the bladder) - perhaps not a biggy, but, for me, a bit disconcerting.

    I couldn't have the UroLift, else I would have done it. The surgeons I talked to did say that as it is new, there is some uncertainty about how long it would last, but they thought it ought to be little worse than any prostateactomy. Plus there are somethings that are supposed to slow/halt prostate growth.

    Best wishes, Ian

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    • Posted

      Hi IanC. I'm just curious as to where your Holep was performed. I had it done at the Mayo Clinic in Phoenix. I couldn't have Urolift either, but now I'm glad I didn't

      Best wishes,  Ron 

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    • Posted

      First of all I would never have anything done that wuld give me retro.  Had it and don't care for it.  Life is hard and there not taking anything else away from me.  I had a urolift done a year ago.  It was great have no problem.  And my orgasm are more intence. The uroift has been around for 10 years.  Mybeen doing it from 2013.  He has done alot and all the men are happy.  He has told me that he does not do the older procedure to muchbecause men are looking for more then just to pee. They want to keep there life just the way it is..  Take care  Ken    
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    • Posted

      Mark that is very good advise.  Doctors do not feel we need it when we get older.  They tell you very little or tell you all will be the same.  But it's not.  Have a good day  Ken 

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    • Posted

      I had GL in 2004 when it was relatively new and they did a bladder neck sparing version to avoid that in order to preserve ejaculation wherever possible.
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    • Posted

      Being a younger person, basically GL is castration. But when your prostate is so enlarged and the urine can not get out you have to do something. My GL worked but not having semen is basically being castrated to a certain extent. If you are over 70 years old, GL is OK. 
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  • Posted

    I had GL PVP (75 gr prostate) in 2005 and was happy with the instant recovery but not a terrific flow. I did not have retro. My prostate regrew to 125 gr.and last year I had Thulium laser surgery with a slightly slower recovery. Someone here said that his Uro told him that prostates continue to grow like weeds.

    Urolift seems to be effective but I cannot see what is going to stop it from continuing to grow as nothing has been taken away and ten Grand is a lot of money.

    While I was happy with PVP last years surgeon was very much against it saying that it is a commercial procedure and not a cure. Much of the cost for PVP is for the use once laser rod.

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  • Posted

    Tough choice. My previous Urologist said that there was a problem with Greenlight and that he had to do all his patients all over again, with the TURP. He said that the Greenlight caused abrasions [or something like that]  in the Urethra. I didn't want either the Greenlight or the TURP so I waited until the Urolift came along. I'm 86 and I figured that this new Urolift made more sense than any other.

    I had it done about 3 weeks ago and my initial reaction was very positive but now with each following week it seems to be going back to my original symptoms that prompted me to get the Urolift. It's still a "little better" than before the treatment but I thought it would improve more with each week. That hasn't happened BUT it may be too early to judge the results. Here's another possible suggestion. I have a 77 year old frined who decided that his solution was to do a selt-catherization.

    Each night he inserts the catheter [along with a bag for the urine} and he sleeps like a baby, then wakes up wiith a bag of urine. Does anyone else in this group know anyone who does self-catherization? If my Urolift doesn't give good results, I may end up with doing the self-catherization.

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    • Posted

      One of the first UK Uro's to do Green Light (not my one) later told me that they initially thought that GL was a quick and easy procedure but they later realised that they needed to to do it slowly and with more care.  
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    • Posted

      There are a number of posters in the BPH threads who do self-cathing. Many have perfected the technique and just insert the catheter and go every four or five hours, completely emptying the bladder. I was afraid that I was approaching full retention a couple of months ago when the meds quit working and I had to find some way to last until my Holep appointment on Oct 31st. So I tried self-cathing and couldn't get the thing in. My urologist provided a thinner one and I was able to insert that one, completely emptying my bladder for the first time in at least ten years. I have to say that going for four hours or so after years of going every 45 minutes in the day and four or five times at night was an amazing feeling of relief. Fortunately, the meds did kick in, sort-of, and I was able to make it to my Holep surgery without further emergency.

      After having done it once I know I could do it again, it's a learning process like anything else. I was extremely careful to be immaculate and careful, maybe unnecessarily so. I say go for it, I used the  reddish-brown one with the turned-up tip to help get through the prostate. It also had a little button where you grasp it to indicate the position of the turned-up tip. It was very thin and I would definitely use that one again. 

      I expect to be through with prostate problems as my Holep was an amazing, off-the-chart success and my surgeon tells me that only one percent of his Holep surgeries ever require another procedure.

      There cannot be a procedure less-painful or troublesome than my experience has been. I'm literally overwhelmed.

      But try the self-cathing. Like me, you may come to a point where you need to know if you can do it. Knowing that you can avoid the emergency room is an enormous plus and you may find that you can do it indefinitely. There is one caution; one of the posters I read developed a minor pain and ignored it. it was an infection which got much worse causing him to lose a testicle. So, if it hurts get to the doc for antibiotics immediately.   

      Good luck and keep us posted.

      Ron

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    • Posted

      Hello Ron,

      Did you get both Urolift and Holep?  I'm researching the best route for my BPH and trying to get as much advice as I can about different procedures.

      Thanks,

      Evan

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    • Posted

      Good afternoon.  Don't know how old you are and if retro ejaculation is a concern of your.  They can do a Urolift up to 80 ml Some doctor will do it up to 100 and if you have a median lobe they can pin it to one side. This procedure they keep on saying that it is new.  It was new when I had it done over 3 years ago. With trial 2 years before that.   I was number 20 for my doctor  I have no problem with the urolift My prostate is wide open.  It can last 5 year or more.  Just like any other procedure.  We have had men on here that have had 2 turp or a turp and GL in a couple of years.  I feel sorry for themm that they had to do it all over again. .  Just because you have one does not mean that your done that is up to your prostate.  You still may have a repeat with any procedure.  For me If my prostate grows and I need a few more clips so be it.  It is a easy procedure and you can see result in a few weeks.  And there are no side effect like the others.  Take care and do your research before you pick anything.  Good Luck  Ken     

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    • Posted

      Hi Ron,

      I know this post is old so I hope you are still around.  I am looking for help for my dad who is almost 87.  Despite a stroke from anesthesia about 12 years ago that left him unable to speak and one arm paralyzed--he has felt good and has been enjoying life.  A few years ago he began being incontinent and the Uro said he prob had retention and needed a cystoscopy.  Well he had one done and left the foley in there till we decide to do the Green light (which he said was our ONLY choice)  well my poor dad as I type is in the hospital with a horrible infection.  So hard to see him in such pain.  And we don't know what to do!  The foley/cystoscopy and infection have really debilitated him.  I don't know how he will withstand surgery.  Was the Holep painful?  How was the recovery and do you think it would be safe for a senior?  I would love for him to be able to self cath till he builds up his strength but he only has one hand.  Thanks for any advice.

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    • Posted

      Laura  so sorry for your father.  At 87 I would not put him through that surgery..  There has to be something else to do.  Have you looked into Suprapubic Catheter.  They would put it in through a small incision above the pubic area.....I think this surgery would be much easier for your father and for you  guys to take care of.  I am sorry but who know if the Green Light will work.  The doctor does not know until it done and if to don't you put you father through something he did not need.to go through.  This is only my opinion.  There is another man on here Frank  He is 89 and the doctor wanted to do surgery on him they only give him a 50/50 chance of any surgery working.  Think about what you are doing.  Good luck and god bless  Ken  

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    • Posted

      The surgeon who did my GL procedure said that he had performed  it on a man of 92 with a 120 grm prostate as he described it as a 'very gentle' procedure. However with your fathers previous reaction   to anesthesia I would imagine that they would not want to risk that again leaving a spinal as the only alternative.

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    • Posted

      Derek & Laura   When picking a procedure we really don't know if it will work.  It is the only procedure the doctor is suggesting.  There has to be something else that would help him. But we have to look at his age.  Look what happen when he went in healthier 10 years ago.     My doctor has worked on patients over 90.   I know the way my doctor feel I can not speak for your fathers doctor but my doctor looks at the health of the patient and he will only do the lease stressful procedure for that patient. I don't know if a spinal would be good for your father either after a stroke   What ever procedure you pick you your mother and your father have to sit down and discuss it.  I know you want to help your father but I think you need to get another doctor involved and the health of your father has to be considered.  I know this is hard for you but we try to do the best for out loved one.  God bless you.  Ken .   

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    • Posted

      Yes, Kenneth, the gentle procedure and at his age he does not want a brutal TURP and just enough taken away to relieve his symptoms. We don't know which part of the prostate is causing the problem but at 87 I doubt if your dreaded Retro  is a concern if it is a large median lobe. 

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    • Posted

      Yes Derek It is much better then a Turp and I am not worry about retro for him  but I am worried about him going through that surgery especially if there were not the right test to see what is the problem.  Do you know if he had a MRI to take pictures of his prostate.   They need to sit down with the doctor or get another opinion.  Also they need to talk with a anesthesiologist to see what can be done.  This problem was cause by his last surgery if I remember right.  He had no problem going to the bathroom before his last surgery.  I just don't want him to go through something that is not going to fix his problem.  He is not like a lot of the men on here 50 or 60 that if it does not work we can look to try another procedure.  I know you had a couple of GL but you were in different health.  Or there is my other friend in the UK.  John R  He wanted a Urolift first but when he went to the doctor it was to late  for him  He was just 75 last week and he had the GL yesterday in the UK.  Don't remember the hospital but he said it was very nice. he feel great But he was in better health then Laura's father They need to go slow and get the right procedure that will help him.  GL may be the one but I just don't want that doctor going in blind and just cutting away.  It may cause him more problem.  God bless you and Good luck to him  Ken   

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    • Posted

      He has BPH and that was not what was caused by his last operation. If you read my posts I always try to call GL and Holep prcedures and not operations as there is no cutting or stitching involved. I wish that GL had been around in my father in laws time as he was in his 80's and in poor health so could not have a TURP. They fitted a stent that had to be removed and then he had an in dwelling catheter for the rest of his days. 

      The only advice that Laura can take is that of an expert who knows her fathers condition and needs and who will do what is in his best interests.

      I assume as she uses the word 'Seniors' that she is in America and not the UK. We don't know if he is being seen in doctors or urologists office or at a hospital perhaps at his age it is a VA hospital.

      I can assure her that GL is in no way painful after the procedure apart from some stinging at the start of urination.. There was some morphine in my drip after each of my laser procedures but after that I did not need anything. 

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    • Posted

      Derek I know from watching about 6 videos and reading up on it they use a laser and do section to remove the tissue and it is much better they a knife.  I just worry about how they are going to do it.  That is why they need to talk with anesthesiologist to see what would be the best for him.  They need the picture of the prostate to see what the problem is.  He is going to have to have something to help.  At 87 he needs to enjoy the rest of his day.  My father was 82 when he died never had a problem and I have a brother 75 No problem.  But I just wish they can to something  Ken   
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    • Posted

      Thanks for everyone’s input. I am so impressed with this great community of people helping each other. I’m still in the hospital with my dad. He had less pain today but still on intravenous antibiotic.

      Yes I am in the US NYC area.  Did your father in law do ok with his indwelling catheter?  I hate for my dad to have one but better that than lose him as anesthesia is the biggest concern.  They had a urologist poke his head in the room. He was pretty useless. I asked him about GL versus Holep and he didn’t know what I was talking about.  He suggested the TURP and ran out the door. 

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    • Posted

      By the time he had the catheter he was more or less confined to bed.

      On this Forum it is difficult to believe that Urologists like the one you met still exist but the fact is that TURP is still the most performed procedure for BPH even in America. I ran a mile when it was suggested to me in 1995 and waited for one of the laser procedures that was being developed. It was a long wait before GL appeared. It has been improved over the years and is now in its third version.

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    • Posted

      I was concerned before my GL as my mother had memory problems after surgery. I voiced my concerns to the anesthesiologist who assured me that he did not want me to die on him. He was not satisfied with my EKG and ordered an echocardiogram that eased his mind. He as others since then went through my medical history in great detail. in my last operation a year ago they held it back for about two hours because I had milk in a cup of tea before I left home over two hours before. 
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    • Posted

      Derek  I was only concerned with one of my surgery's .  It was when I had my heart ablation about 2 years ago.  I was out for 9 hours and it took me all most 3 to wake up.  I was very tired and the only thing I could said when I woke up was why is my wrist wrapped up and I was told not to touch.  I found out later that it had something to do with my blood pressure.  It was a IV just in case something happen that could give medicine in a hurry.  I told him that I did not care but I should have been told about it before the procedure.  They told me about everything else.  It's just I like to know what is going on.  Ken

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    • Posted

      Thanks Derek. My dad usually walks around the lake with mom everyday and goes up 15 steps at their home. Do you think for someone of that activity level the suprapubic catheter would be a hindrance? My alternative thought was that this could be an interim step. He could get rid of that awful foley and regain his stamina and then maybe have something else done in the future.  I can’t tell how easy/challenging the supra is. Doctors make it sound like a breeze, but they make everything sound like a breeze. Yes that awful doctor literally was in the room 5 minutes and took off! That was our “consult” 🙄

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    • Posted

      How long has he had the foley in ? People on here seemed to have coped with a supra pubic one quite well. I had one after my aortic valve was replaced as they could not get a conventional one past my prostate in the operating theatre. I can't really say much about it as my walking was rather limited for the few days I had it  as I was also connected to an ECG monitor and a bag collecting fluid from a lung.  

      I had an ordinary one for a bit after my second laser prostate surgery and got around OK with it and travelled on public transport and went to the races.

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    • Posted

      He's had the foley in for 3 weeks.  His PCP ordered a pelvis scan and came by the hospital.  He said we have to decide quick!  He said my dad's prostate is the size of the little hospital apple sauce container which is apparently huge!  I think we'll have to go for the suprapubic as I just don't think he's hearty enough for the laser procedures.  Thanks all for your help and I'll let you know how it turns out.

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    • Posted

      I was told in 1995 when mine was 35 grms that I needed a TURP as a matter of some urgency. I ignored that and it was 75 grms before I had GL in 2004. It regrew to 135 grms by 2013 when I had another laser procedure. I'm sorry I can't relate that to the apple sauce container.

      They obviously want to do a procedure because of its size. If they prescribe Finasteride/Avodart any reduction in size would take months.  

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    • Posted

      I don't understand the little jar of apple sauce size chart.  Most urologist use fruit size.  I know before I had my Urolift I was told that mine was the size of a large lemon.which with this chart is 50 g  They use a transrectal ultrasound.    Here is what the rest said......Normal Size ( Chest Nut ) 20 g...Enlarge Prostate ( Plum ) 25 g....Enlarge Prostate ( Lemon ) 50 g.....Enlarge Prostate ( Orange ) 75 g.....Enlarge Prostate ( Grape Fruit ) 100 g They also gave you what the occupies of the rectum lumen of each was.    There was a total of 150 men in this study.     

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    • Posted

      The patient was probably having his dinner when the Doc came round and pointed to the nearest object.

      My last one (135 grm)  must have been a Melon though the one I have in the kitchen weighs much more than that.

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    • Posted

      Yes they only went to the 100 g mark so it most likely a cantaloupe size.135 g.  I am glad I found that chart.  Some men on here when a doctor tell that the size or 75  g or so they don't understand.  I know it's almost 9PM by you.  I'm just going to eat some dinner.  Have a good evening  Ken   

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    • Posted

      Prostate tissue has essentially the same density as water so 1g=1cc.  Many urologists describe the size of the prostate in cc or ml instead of grams since they are equivalent and they can estimate the size with a DRE.  Anyway, 135g is nowhere near the size of a cantaloupe.  1 fluid ounce is about 30 ml so 135 ml (or g) would be less than 5 fluid ounces, a little more than half a cup.  More like a lemon than a cantaloupe.
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    • Posted

      Lee I am just saying the why they were describing in the article The study is aimed at determining the reliability of DRE in estimating prostatic volume.  They use grams. This was done in a teaching hospital in 2008    Ken  
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