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

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 

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

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.

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. 

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!