Posted , 14 users are following.
It used to be pretty much just TURP, but now there are lots of way to fix BPH, which more coming on board each day. A partial list includes: Green Light, HOLEP, Urolift, REZUM, iTind, PAE and FLA.
But if you read the literature, or spend time here, what you will find is that all of these procedures can produce great results or not so great results. And that is often with the same doctor.
So, in broad strokes, in many cases it's not the procedure or the doctor that determines whether a surgery or procedure will work, but the condition of your bladder/urinary system going into the procedure.
Unfortunately, many doctors operate first and then make excuses when the operation or procedure fails. "Well, the operation WAS a success, but you really can't expect much with such a weak bladder".
Very nice piece of information to know, after the fact!!!
The more knowlegeable and ethical doctors will test the system first to get a better idea of outcome before the surgery or procedure. So far, urodyamic testing is the gold standard here, with video urodynamics the best of the best. Still, urodynamics has limitations, and is not the genie in the bottle.
Recently, a few of us in the self cathing group, were playing around with a way to use our catheters to open up the urethra in the way a stent might. The idea was to simulate with the catheter what a prostate reduction surgery often does, ie take the pressure off of the urethra. Problem is that a catheter is not really a stent because the catheter itself becomes part of the obstruction.
This lead me to think, what we really needed was a trial by stent. In other words, simulate a prostate reduction surgery or procedure with a temporary stent to see if indeed its worth doing the surgery or procedure.
Turns out, this has been thought of before. Problem is, as with many good idea, not much progress or effort has been put it into the idea since 2011.
From the 2011 paper:
"An interesting application of the biodegradable stent is to simulate the situation after the TURP in patients with a combination of severe BOO and severe overactive bladder. "
The cynic in me says not to expect too much in the way of more progress and funding in this area. First, these projects need funding and most of the funding these days is coming more from the equiptment and procedure manufacturers (think Urolift and REZUM) and not from stent manufacturers for a diagnostic use. And second, a trial by stent would be added time and work for the urologist, when in fact many are really chomping at the bits to either cut, slice, dice, burn, melt or lazer away your prostate.
However, on an individual basis, this doesn't mean someone motivated to find out before a surgery, if that surgery will actually work, couldn't hook up with a creative and enlightened urologist and do the trial by stent on their own. Not to say that may be easy, and in fact, if one does find such a urologist, please private message me their name!
I will post links to the only two studies I could find on this in my next message. They probably won't show up for a day or two until they come out of moderation.
3 likes, 138 replies