Im having anxiety about consultant seemingly delay green laser for BPH operation

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Hi, I've been on tamulosin and dutasteride for some 10 years and without them I would be unable to pee. At the age of 66 I am becoming stressed with getting up 4 to 7 times most nights and had a blockage two years ago. Ive had my psa checked at 3,8 and had a MRI scan which showed a prostate size of 70 grams. The consultant wrote a letter recommending me for green lazer but then, 4 weeks later, the consultant who would do the op says he wants to test me for nocturna and then delay things even more by doing more tests. Im not happy about this and feel he is stalling me for what ever reason. I had a period where I was peeing more volume at night but generally Im doing pees of between 100 to 220 day and night, so the consultant has seemingly used this short period of peeing more at night  as a reason to get me on a hormone to reduce volume at night. This will delay things by about 6 weeks and then he wants to do other tests. I was so astonished that he was taking this tac, that I couldn't bring myself to ask what these  further tests would be for. The meeting was one sided and I felt like he thought I had just started with BHP.

I'm just at a loss as to why one consultant recommended green lazer and then the actual green lazer consultant then wants to do these other tests. I feel that after 10 years of taking tam. and dutast I am only going to do more permanant damage to kidneys and Bladder and am annoyed that I am being seemingly stalled, Ive also had a dizzy spell about a year ago which Ive since realized could be the affects of the two pills Im taking. This lasted for about  a week and was very scary as it felt like I was dropping through the floor.

I've raised my concerns with the first doctor and am waiting to see  what the outcome will 

be. If not satisfied one possibiltiy is too ask for another opinion from another consultant, different hospital, which Im loath to do but Im losing trust in the doctor who is seemingly stalling me. 

I'm at my wits end and as well as not sleeping well, Im fretting over this incident.

I just wondered what other readers think about this.

On the same topic can one buy these self catheters on line or in a chemist and can one learn to self catheterise on line? 

Thanks in anticipation

Breeze61

This is my first post, I think, even though I had joined 6 years ago possibly because of my BHP. Also, please excuse any spelling mistakes as its 4am in the morning and I just wanted to get this on paper.

0 likes, 10 replies

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10 Replies

  • Posted

    Breeze  So sorry that your going through this but it is better to be sure than have a surgery that may not work.  You should go and get a second opinion.  Please have faith  Ken 
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    • Posted

      Hi Kenneth 1955  and Jimjames,

      Thanks for your input, I feel a lot better having a bit of support from people with experience of what is happening. I will try to be patient and relax.  

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  • Posted

    Sorry about the anxiety you're going through. That said, I think being checked for nocturia, prior to Green Light (or any prostate reduction surgery) is a very good idea, and in fact something that should be done in most cases by uro's, but often is not. 

    Briefly, nocturia is when more than 40% of your total urine output is at night. You don't need complicated tests to find out, just a five dollar plastic beaker marked with ounces and milliliters and a paper and pencil. Simply do a few 24 hour void logs writing down the time and amount of void. The math is very easy.

    The reason why this is important prior to prostate reduction surgery is because many people with bph/luts cite waking up at night as the prime problem. If the issue is a large post void residual, prostate reduction surgery can often help. However, if the problem is nocturia, the surgery may not help at all. 

    I won't talk to whether or not I agree with hormone treatments at this point, but doing a simple void log is a great idea, as well as delaying surgical treatment until you have as much information as possible so that your expectations going into the surgery will be more reliable. 

    As to kidney damage, a simple bladder/kidney ultrasound study should tell you right away if there has been any damage. 

    To your question regarding catheters, we have several threads going on self catheterization, which is a very reasonable alternative to Green Light or any other prostate reduction treatment. It is the choice that I personally made over three years ago and haven't regretted it. 

    Yes, you can buy catheters online with or without a rx, but if you have insurance, it's best to go through one of the larger online catheter distributors who will do all the paperwork for you and coordinate things with your doctor. 

    Feel free to respond in one of the self catheter threads or send me a PM (private message) if you have any more questions on self catheterization.

    And get some sleep and don't stress. View the delay as something positive to get things right.

    Jim

    Jim

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  • Posted

    Earlier I read about a procedure called Focal Laser Ablation. You can see its details on you tube. I wonder if it can benefit the patient like you. I know how hard it is to get up many times a night to pee. I myself get up 3-4 times but I am trying to manage it so far without medication. Good luck to you.
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  • Posted

    Hi Breeze,

    First things first, you're not alone. It is distressing when you feel you're not in control of things, that things are happening or not happening and you don't know why. Information is King. You can't make decisions until you have the information to do so. You have come on here and started down that path, good for you, you're on your way to dealing with your problems. In the defence of your consultant it is actually a good thing he/she is doing. Why? Because they don't want to do anything until they understand your problem. Too many people come on here and complain that there Urologist has decided what's best for them based on what they believe is what best, without taking into consideration the alternatives or what you want. There are now a number of options available to you, some of which will be determined by your individual circumstances others just pure choice, your choice.

    You've lived with your condition for a long time, this not the time to make hasty and rash decisions. You have to be comfortable with the choices you make, and that can only happen once you have taken the time to understand what might be right for you, and to question what you are being told to the point you KNOW it is the right thing to do. The starting point for me was what is the least invasive procedure and offers the most flexibility. You have tried the drug approach and found, like most frankly, that they are not effective enough, either alone or at all. That was my conclusion too.

    I would use this place, as you have for the last 6 years to read around all the procedures that others have experienced and written about. Start with PAE (Prostate Arterial Embolisation). This is one of the latest and least invasive options for you to consider. It might not be right for you, I'm not your Doctor, it might not be something your Urologist even knows about, which would make me question their credentials, but it is an option that does not preclude any others should it not be ultimately successful, and for that reason alone I would make it your first option to study. Next are the more invasive procedures such as green light but also Rezum, FLA, Urolift, ITIND etc etc. Like I said there are quite a few options, all of which you can research on here and of course the Internet. You have plenty of time even though I can tell you are anxious, bordering on desperate, don't let this panic you into making an uninformed decision. 

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    • Posted

      Thanks Truthmatters, 

      Thanks for the time in writing, I appreciate it.  I must admit I've not read about PAE so will do so tonight.

      I would have the NHS should have regional centres of excellence for this common male problem which can blight ones life. 

      With hindsight I should have checked in with my docter earlier but I was generally managing ok on the pills until 6 months ago and getting up 6 or 7 times a night is no joke.

      Breeze61

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    • Posted

      Just a caution:  PAE may not work if you have an enlarged median lobe (the success rates are much lower).  I tried it anyway and unfortunately it didn't work for me.  I'm now considering FLA which, while a bit more invasive than PAE, is less so than most other procedures.  You might want to read up on FLA as well.  

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    • Posted

      Which part of the UK are you in as availability of procedures varies greatly. Quite a few areas still think TURP is the Gold Standard treatment and will not refer patients to other areas although you are entitled to that choice for procedures they do not do. 

      Last  year GL XS was made the treatment of choice in the UK by NICE for NHS patients

       

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  • Posted

    I can speak to the self cathing.  It is a viable option while you're trying to figure out your next move.  I've been doing it for 3 years.  I find the coloplast speedi-cathcompact male to be the best.  Your Dr. should order them for you and you should learn how to use them from a nurse.  I was very apprehensive but learned it in 5 minutes and it gets smoother over time as you practive.

    Best of luck!

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    • Posted

      Thanks Arlington, 

      I will arrange for the lessions and equipment with the doctor. As you know its very distressing not being able to go and very dangerous.

      Breeze61

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