Holep vs. Green Light vs. TURP

Posted , 20 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

.

0 likes, 67 replies

Report / Delete

67 Replies

Next
  • Posted

    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.

    Report / Delete Reply
    • 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.

      Report / Delete Reply
  • Posted

    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

    Report / Delete Reply
    • 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.

      Report / Delete Reply
    • 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.

      Report / Delete Reply
    • Posted

      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.

      .

      Steve - who is also over 60 and very physically active

      Report / Delete Reply
  • Posted

    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

    Report / Delete Reply
    • Posted

      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

      Report / Delete Reply
  • Posted

    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.

    Report / Delete Reply
    • Posted

      LOL... I hear ya Brother.

      .

      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.

      Report / Delete Reply
  • Posted

    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.

    Report / Delete Reply
    • Posted

      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

      Report / Delete Reply
    • 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

      Report / Delete Reply

Join this discussion or start a new one?

New discussion Reply

Report or request deletion

Thanks for your help!

We want the forums to be a useful resource for our users but it is important to remember that the forums are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the forums is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.

newnav-down newnav-up