Holep vs. Green Light vs. TURP
Posted , 24 users are following.
Good Afternoon Gentlemen & Ladies,
I just left my New Urologist's office (Stanford Med Center) yesterday at 5 pm. Long story short...
I am now narrowing down my final decision for seeking a resolution to my many years of BPH. I know we are All Different and have to find our own "Best Choice" to our own issues.
To give a bit of insight into my particular situation: - I'm over 60, very physically active, 35 years marriage, 2 adult kids, a relatively small prostate size, 38 grams, which is apparently growing inward and squeezing the urethra, more than it's growing outward. The CT Scan with & without contrast dye shows the prostrate is also pushing in on the bladder. No median lobe, strictures, or other side issues. Have been using CIC twice a week to keep my PVR's down from 100 to about 40-50 ml. I sought out PAE, both at San Diego State University Medical Center and Stanford University Medical Center. I was informed by an IR Doctor whom I respect, that I am not an "excellent" candidate for PAE, due to their preference to utilize PAE on sizes of 50 -100. Can NOT afford FLA, have ruled out Rezum, Mono TURP, and Urolift.
After much reading/research, having many DRE's, Ultrasounds, Cystoscopy, Flow Tests, trying various "Medications", and seeing 3 different Urologists and one Interventional Radiologist, I have come to the the conclusion that I want to cease battling this affliction and move forward with my Life and will likely get one of the following procedures in the next month or so.
Holep -
Green Light (PVP) -
TURP (button) -
At this time I would appreciate your valued thoughts, experiences, and rationale opinions on which procedure you believe has the Best Overall results. Feel free to include negative aspects of each, but please limit them to personal experiences, not third/fourth hand stories.
Thank you all in advance. And rest assured, I will keep you All updated as my procedure progresses, for other folks who follow and have yet to make their "Choice".
Respectfully,
Chuck
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0 likes, 71 replies
alex23431 chuck68670
Edited
As you describe your situation why do you need a surgery at all? Do you have any symptoms? Do your urologists told you you need a surgery? My urologist told me that 300ml PVR is OK. Of course it might be because my bladder is very much stretched.
chuck68670 alex23431
Posted
Yes my Symptom rating scale is 29. Basically can't get much sleep due to getting up to pee, and then can't pee much, then can't go back to sleep, then getting up again to do the same thing about every 2-3 hours. Lack of sleep ruins one's Life. Also... if I was not CIC-ing, the PVR's seem to snowball and get higher, as the pressure builds. I do NOT want to stretch my bladder, by waiting too long and then have problems with that AFTER having a procedure.
alex23431 chuck68670
Edited
In this case you are absolutely right to look for the solution.
Good luck!
Motto chuck68670
Posted
One thing you can do while you decide to keep from stretching your bladder is self catheritization. CIC. You can buy them without a prescription.
Light1 chuck68670
Edited
Chuck,
Why have you ruled out REZUM? I had it at the end of June. I can pee, and no nasty side effects. Worth looking into IMHO. You can PM me if you want more info. Also 100ml PVR is low. Why the concern?
Best,
Fred
chuck68670 Light1
Posted
Thanks for your thoughts on Rezum. I just know of too many complications that I do not want to risk. As far as PVR's...
Basically I can't get much sleep due to getting up to pee, and then can't pee much, then can't go back to sleep, then getting up again to do the same thing about every 2-3 hours. Lack of sleep ruins one's Life. Also... if I was not CIC-ing, the PVR's seem to snowball and get higher, as the pressure builds. I do NOT want to stretch my bladder, by waiting too long and then have problems with that AFTER having a procedure.
ken19524 Light1
Posted
I agree about Rezum. There have been a few who reported problems on this site. But for me and thousands of others, it worked very well with no side effects.
steven05114 Light1
Edited
Here's to suggesting another Rezum. I had mine at the end of November 2019 and it cleared my blockage without any complications and that was after 10 months of catheters. That your prostate is small and pushing up into your bladder certainly suggests a median lobe.
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Steve - who is also over 60 and very physically active
steven05114
Posted
Oops, that should be November 2018...
dermot16441 chuck68670
Edited
Just wondering what your other symptoms are. A PVR of 100 is not huge.
And did you mean to say you cath 'twice a day' rather than twice a week. I cannot understand how cathing twice a week would keep PVRs down for long. Please clarify, and somebody may be able to help.
Regards
Dermot
chuck68670 dermot16441
Edited
Dermot,
I do indeed mean twice a week. By cutting off my liquids 4-6 hours before bed, and doing natural voids a few times before bed. And then every 3 or 4 days following that routine with CIC-ing, I have been able to seriously reduce the "pressures" on my bladder and subsequently my regular PVR's. Apparently I have the bladder capacity of a humming bird. Although it was not always this way, and seems to have only become an issue since having BPH. My flow has been measured several times and is about 4.9 . And going years without much deep sleep has cause me serious side "issues" and difficulties, as well as sunken dark circles around my eyes. I am very ready to move past this BPH challenge.
Chuck
Geezer chuck68670
Edited
I'm 78, have had BPH as long as I can remember. I have had all three, beginning with the green light and followed by TURP ending with the HOLEP. Had so much scar tissue from biopsies and the other procedures not much choice was left. Finally had the HOLEP last year. You might want to consider the holep if you're going to end up there.
chuck68670 Geezer
Edited
LOL... I hear ya Brother.
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I have read many of your posts and understand what you have endured. My hat's off to you for your valiant fight sir. Holep is what I am leaning towards, because it does sound advantageous to my individual situation.
alex75915 Geezer
Edited
Hi, just read your post, i am having serious issues, and considering rezum/greenlight/turp, but never heard of HOLEP, what is it ?, please, advise, did it work for you ?
mike24933 chuck68670
Edited
I can only report my experience of button TURP. After many years of struggling on Tamsulosin and Dutasteride I finally reluctantly opted for the operation just over a year ago. The procedure caused me no problems and resolved my symptoms completely.
chuck68670 mike24933
Edited
Mike,
Thank you sir for your information. Was there any recommendation on prep for the buton TURP or during recovery, that you can share ?
I too suffered the trials/tribulations of the "chemical" methods. Both caused me bad problems; one almost cost me my 30+ year married. It made me not care about anything or anybody... including myself. I woke up every day the same. No good days, no bad days, just days.... Nothing seem important. Nothing seemed to matter. * I was subsequently told that Alpha blockers can have psychotropic effects on people. HECKA--DOODLE ! - One would think the Doctors might wanna mention that little tid-bit of important information to their Patients. Best to you sir.
Decorously,
Chuck
mike24933 chuck68670
Posted
Chuck,
There was no preparation other than not eating on day of op'. Afterwards you just have to be prepared to take it easy and not lift anything heavy for a few weeks. You can walk about and do things as long as you are careful not to strain yourself. When you first come home you need to stay very close to a toilet for a day or two because you get very little warning! I had some blood at the start of urinating for a few weeks. This was nothing excessive. It stopped before 4 weeks. I do a bit of cycling and I didn't use a bike for three months. I did actually get a urinary infection after about 2 weeks which caused frequent need to urinate but this was cured almost instantly by Trimethoprim which I already had (I asked the consultant to give me a prescription for these when I came out just as a precaution because I didn't want to have to go through the process of trying to get an appointment afterwards). Afterwards I wished I had had the procedure earlier but I know in fact that I would never have had the surgery if I could have avoided it. My feeling about the whole thing is that the result is probably dependent on the skill of the surgeon so it is worth doing what you can to find someone you feel confident in.
Mike