I've been booked in for TURP but not sure about it.

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Hello there,

I have been having problems urinating for some time now.  This takes the form of slow flow (sometimes very slow but it varies), some discomfort at times (not pain exactly, or soreness) when urinating.

I don't need to get up in the night and have no problems with bladder control.  On occasions I feel a need to go shortly after finishing urinating but not regularly.  I am fairly sure I am emptying my bladder.

I was referred to a consultant who did an ultrasound (external) scan of the area and a digital rectal exam.  He showed me the scan and said I have an enlarged prostate, probably benign and booked me in for a cystoscopy in preparation for a TURP.  No other suggestion was made.

I had the cystoscopy which was very painful and he saw me in the recovery area for a few minutes but I don't remember much of the conversation.

After two months I had heard nothing and chased it at the hospital.  Eventually they told me that the forms had not been signed and they dealt with it and sent them off.  

The next letter I got was a date for the TURP procedure with no appointment to discuss it with the consultant before.

I have arranged a consultation with him but having read a lot on this forum am not very happy about proceeding.

It seems that my symptoms are not as bad as any of those I have seen on the forum and wonder if TURP is a bit "overkill" in my case.

I would be very grateful for any advice anyone can give me.

I am sorry about the length of this post.

Thank you very much,

Richard.

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15 Replies

  • Posted

    have you looked into urolift and holep surgery . if you have urolift done and it

    does not work you , surgery is always a second option .

    check both of these out on line , read up about both procedures then go to your

    urologist and talk to them which one is best for you.  best of luck make sure you make up your own mind on surgery and what type of procedure to have !!!

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    • Posted

      Thank you for that. I have read a bit about urolift but only in this forum. I will do a bit more reading this morning before I see my urologist. I am seeing him today and will ask about them. I think I need more time to make what seems like a very important decision. Thanks very much.

      Richard

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  • Posted

    HI Richard

    Urolift is a good choice to start with because you are still a canidate for surgery if it does not work .

    If you have to go the surgical route I strongly encourage you to check out

    holmium laser enucleation of the prostate ( HOLEP ) .

    What about the natural way to prostate health ?

    Taking saw palmetto , beta sitosterol , promengrante extract , pumpkin seeds

    boswellia gum extract , stinging nettle root powder , lycopene , selenium

    zinc picolinate plus copper , quercetin , green tea extract , swedish flower pollen

    cranberry extract .

    for the last two years i have been dealing with chronic bacterial prostatitis

    finally after three urologist's i don't have severe pain anymore .

    I was looking into holep surgery but there were no hospitals locally that preform

    the procedure.

    I would have to travel 250 miles and would be out of my health care network

    provider , so i would have to pay 50 % of the cost which is $ 20,000 To $ 30,000

    dollars in my area .

                                               I wish you the best of luck  griff 

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  • Posted

    Hi Richard,    I sometimes think on this forum it can be a problem understanding what options are available in your country, and whether if you live in the UK you are under the National Health Service or Private.  The NHS can also differ between Scotland and England for us and what is offered in your local area. I have had TURP but no other option was available as could not pass water and had to be done quickly as they could not get catheters in.   Sometimes it can be harder when too many options are available and each person reacts differently.  Good luck with whatever choice you make.

    David

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  • Posted

    Hi there, i have replied on this forum at lenght bbefore!! So, i am 12 months  since standard TURP...op done in UK..North Devon., i did not have classic BPH, but a semi blockage at the neck of Urethra and prostate bladder channel! the affect was like having a UTI all the time!!, when various  drugs failed to clear.. it was decided on a turp! now, when i spoke to my consultant obviously he was going to do what he was expert at.. AND what was available in my area!!>>Standard TURP. when i asked about green light laser? his respnce was yes...but we do not do it here!!! no reaction to P>A>E or Holep, only acknowleged!!! So, i did what was on offer. 12 months later i am fairly free of all symptoms except (like today) a strange  feeling in the tip of my penis!! it does not hurt or  inconvienence me, but it is a reminder of the panic stations i was in 15 months ogo!!prior to op! i am 68 now so i guess as the ouycome is good then i cannot criticise the procedeure in any way, and the staff were all great and considerate! i only had a catheter for a day and was home in under 24 hours! bleeding on and off for 2 weeks and considerable discomfort for several months, but no pain !!(great) and a strong urine stream!  side effects ....no problem with sex,but no ejaculation(RE) stronger erections than before! and this is the problem now..waking up with an erection and trying to pee sensibly! and this is how i get this occasional "strange" feeling for a day or 2!..depending on your circumstances i would think very crefully before a TURP (either standard or Green light) enquire about PAE and urolift,.. DO NOT do drugs!! use natural remedies where poss...did not work for me(lost weight i did`nt need to lose!!) but no change otherwise, but they do work for some people. You may have to change health area`s? i did not,  but found out that i could have had Green -light at Plymouth for instance!!70 miles away! there you go, hope this helps...keep positive it will be ok in the end!! and by the way i am an ex pro cyclist...and my troubles were nothing to do with cycling!!..cheers matey..Syd
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  • Posted

    Age matters. TURP and similar procedures are for those who can withstand long, bloody and sometimes painful recovery procedures.
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  • Posted

    It sounds as though you arent' bad enough to require something like TURP. have you tried alpha blockers? (Alfusozin, Rapiflo). They might completely resolve your issue. TURP is a big surgery with a long recovery and not always the best results. I would try saw palmetto,alpha blockers and if that doesn't wor, beta blockers before considering anything else. From your description, if I had your symptoms and TURP was my only option, I'd live with what I have.
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  • Posted

    Hi,

    It was interesting reading your posting. I also started with exactly the same symptoms as yourself about 4 years ago. I too wasn't having to get up during the night and had good bladder control. My GP sent me for a cystoscopy which although uncomfortable showed nothing except a medium enlarged prostate. After waiting 5 months for a urine flow test the specialist informed me that my flow was not particularly good. I have had no urine infections and was surprised to hear from the specialist that my flow would only get worse as i got older. (I was 59 at the time). He then went on to tell me that i had 2 choices, that i could have a TURP which he then informed me would cost the NHS around £5000, and would probably need re doing after a few years, or I could go on medication which would only cost the NHS around £5 per month.! ( but the medication would affect my sex life!) It was as if he was making me feel guitly if I went for the Turp due to the cost. 

    Cutting a long story short, i have been on Tamulosin and Finasteride since then and having no problems. My flow seems to have inproved slightly and and the only negative is that my sex life has taking a tumble.

    If i was in your shoes I wouldnt have the turp as it does seem a bit of an overkill.

    I feel that the Turp should be a last resort. 

    Here in the UK Urolift is only done in a few areas and is expensive (£3500) and as far as i know not available on the NHS.

    Hope all goes well for you.

     

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  • Posted

    Richard,

    At this stage in your journey a TURP is total "overkill" - it would be a last resort, not a first choice of treatment. 

    You should start with the least harmful treatment first, then move on if that doesn't work - this would be a daily, or every other day capsule of FloMax (Tamsulosin) or other similar medication. This should give you immediate relief, but some here hate the side effects. I tolerate it very well and have been taking it for a number of years. 

    If you don't like the FloMax next consider PAE, then next in line would be UroLift. 

    What you wnat is maximum symptom relief with minimum side effects. 

    Also, as the only person here who apparently is a prostate cancer survivor, your doctor can absolutely NOT guarantee you that your condition if 'benign" without a biopsy. Depends on your PSA and rate of change of PSA (velocity). The DRE (Digital Rectal Exam) no doubt turned up with no irregularities, a good sign. 

    It would be very beneficial to you if you consulted with at least another urologist before going under the knife. 

    If you are in your 60's this is a VERY common condition. 

    Tom

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  • Posted

    With obvious attention to what procedures are covered for you, and acknowledgement that we cannot assume that our conditions actually mirror your, I am surprised that any doctor would start with "let's do a TURP" before considering much less invasive procedures.

    As one person noted, a medications combo such as Uroxatral and Avodart should be tried before surgery (unless conditions are really seriously wrong), but another avenue is the use of clean intermittent self-catheterization (CIC), with a frequency matching the need of your urine retention.

    I decided - when pressed by my surgery-minded urologist to schedule a TURP - to instead go with CIC, and initially did it 3x day, and a year ago increased to 4x a day.  My BPH is no longer causing me significant problems, and the CIC procedure, using a hydrophilic catheter, is actually easy after you have done it for a few days.  There is a brief learning period, and some discomfort at first.

    When traveling, whether locally or distance, I simply take catheters with me, and have no problem doing this discretely in any men's room using a stall for privacy.

    There is another thread on this site covering self-catheterization, as well as one covering the PAE proceure, one of the newest and least invasive techniques.  PAE is a procedure done by interventional radiologists rather than urologists (which is probably why so few urologists speak to their patients about the PAE procedure).

    Please explore all other options before you consent to any TURP.

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  • Posted

    Dear All,

    Thank you so much for your amazing responses.  They have given me much to think about and have reassured me that I have done the right thing by cancelling my TURP.

    I had a good chat with my urologist who agreed that I have done the right thing by reading up on it and wants to see me again in 4 months time to re evaluate the situation.

    I will have a more thorough read of all your replies  as there is a lot of information there and I am seeing my GP tomorrow to see if he thinks that a medical route might be a good start and also to make sure I am on a regular check up for cancer.  Again, my urologist suggested that this would be a good idea.

    I will report back again on Friday (I've got a meeting tomorrow evening unfortunately).

    Thanks again for all your support and advise.

    A brilliant supportive network spanning the globe.

    Thanks,

    Richard.

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  • Posted

    Unless I'm missing something, or unless you have significant retention and/or compromised kidney function, I see no reason for a a TURP ir frankly any other operation or procedure. Do yourself a favor and ask the doctor on what basis he thinks you need a TURP as opposed to a watchful waiting strategy that seems more appropriate. An enlarged prostate, in and of itself, does not mean you need an operation or procedure. Depending on what he says, a second opinion with a urologist in a different medical center would be in order. TURP is a major surgery with the liklihood of permanent side effects such as retrograde ejaculation. Do not rush into it, or any other procedure, until you are convinced it's actually needed.

    Jim

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  • Posted

    Richard, I had the identical series of events as you, but without the paperwork hassle. I'd been seeing my urologist for several years, and it got to the point where, like you, I had increasing difficulty in urination, sometimes painful.Climax during sex burned badly.I  Did the Cysto like you in the docs office, and he confirmed that I was a good candidate for a TURP. Truth is, after reading this blog for several months, there are plenty of guys writing in that have gone with different procedures, with differing success. In my case, my doc never suggested anything but the TURP, and I did not dig much deeper than that. My dad had a TURP as did my older brother, it was my turn.

    I could not be happier with my results. I did an overnight stay with a catheder, they sent me home the following morning bagless. I was passing blood and some small clots for a few weeks afterward, no big deal. The only issue I had (and I was warned about it) was that you'll have some urgency issues for several weeks, and when you have to "go" there's no putting it off. In addition, because you're urinating past some raw muscle tissue from the surgery, at the very end of the urination, it gets pretty painful. The good news is it all goes away. My surgery was 10/13/15 and by the holidays I was peeing like a teen, no urgency issues,  no pain at all and I could not be happier. I'm probably a poster-boy (I'm 62) for the TURP. I did ask a bunch of questions, the most important being "Doc, how many TURPS have you done"? He's been urologist for 28 years, so he told me in excess of 1000. 

    I ama firm believer that those of us that have had great luck after a TURP is a direct result of the surgeon and his skill set, pure and simple. I had a green laser surgery some 10 years before, waste of time in my case. In fact, the TURP surgeon had to spend an additional hour on me to "clean up" the scar tissue from the laser treatment. 

    Ask some hard questions about what to expect? I see guys on this blog who spend weeks with a catheder post surgery. I never wore a tube, I just went home. Just as a comparison, my surgeon told me that my prostate was one of the largest he'd seen in years, and when he does a TURP, the usual tissue removal was 10-15cc, mine was over 50cc.

    Do all the homework on your doc that you can. How many TURPS has he done? What type of post surgical issues might you expect? What's the worst you can expect? What about a typical recovery time? etc.

    Lastly. If you plan on having more children in the future, TURP is not for you. In my case, I had a vasectomy when I was in my early 40's, so no big deal. Know that after a TURP, ejaculation during sex is a thing of the past. The sensation is identical, but no fluid. Now, I see guys on this blog that have some difficulty with this issue, I get it. But in my case, the symptom relief I got from the TURP far outweighed anything else.

    Not sure where you live, but if you're in the Phoenix, AZ area I can highly recommend my doc. The doc that did my laser was a younger guy that I'd been seeing for years, but I simply think he was not confident in the laser , as I learned later that he did very little when he did his procedure on me.

    Hope i was of some help. 

    Best of Luck.

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    • Posted

      Well I'm glad you are happy with what you picked but just because your father and bother had it . That's not a reason.  Also you are one of the lucky ones that have the same feeling with your orgasm.  There are many men that have had it done that the feeling is not the same and some even forget about sex because it not the same.  I had dry orgasms with a pill I was on when I first saw my urologist I told him no way did not like them.   When he did my scope he could not get it in the prostate.  He told me about the urolift first.  Never said anything about a turp and coreing out my prostate. I had the urolift done a year ago and still going strong.  My sex life is great and my orgasm are very intence.  And I know about not being about to pee. Went into bladder retenion a month ago from my blood thinner had bladder spasm for 2 hour before thay put a catheter in.  After being flushed for 15 minutes I was still bleeding.  Had to have surgery.  But before i went in I had the doctor which was not mine sign a paper that for no reason was my prostate be removed or cut in any way.  He siign and did the surgery he found 2 more blood clogs around my prostate.  Cut them and urn them and was in the hospital for 3 days.  Had a 24 hour lish with 6000cc of saline going through my bladder.  There is no way anyone is going to take anything away from me..  We are all diffrent and we all have reason we do thing.  But life goes on.  Take care and enjoy all you can  Ken  I sure do  Ken    
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  • Posted

    Richard.  First let me tell you that it seams like he had you booked for the turp before you were in the room  Call and cancel and them him you  would like some meds to relax the bladder.  And then look into some other option.  Do not ruch into anything.  They have don't ever talk to you about it or any of the side effects.  If you can still pee and you don't get up at night Do not let him do it.  PLease.  I had a enlarged prostate My urologist could not even get the scope in it. And never said anything about a turp.  I had a urolift lift done a year ago and I pee great..Please cancel  You will not be sorry  Ken  
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