Incontinence after GreenLight and TURP procedures continues. Looking for hope.

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I posted about having GreenLight (GL) in March of 2016, and being totally incontinent since.  A second TURP was not helpful and neither was months of physical theraphy with TENS stimulation.   I suspected early on that something went wrong with the GL when the doctor came in for my follow-up, and I had been complaining about incontinence, and said, "I almost said no to your request for GL.  Then during a cystoscopy, his reaction (maybe a sigh, or gasp or groan) gave me a sick feeling.  I didn't say anything at the time.

I moved to another doctor at another practice by self referral.  He is great, but two attempts to implant an artificial urinary sphincter (AUS) couldn't be done because he found strictures, and a dilation and then a urothotomy didn't hold long enough to get the AUS implant.

I going to fly across the country to CA to see a top specialist in about 2 weeks, who has specilaized in urethroplasty his whole career.  If he can fix the strictures, then I would eventually have the AUS implanted.  However, I am concerned that it may not be possible after seeing the report of xrays with contrast a week or so ago.  It said this:"Urethra: Normal caliber and distensibility of the penile and bublar urethra.  Multifocal areas of narrowing along the membranous and prostatic urethra measuring 2 to 3 mm."

If it required having a prostatectomy, and urethroplasty to connect to the bladder, followed by an AUS, I'm willing to consider it.   It may take a major bite out of my savings (the CA doctor doesn't accept Medicare... so that would be out of pocket.)    

Ultimately, I may just have to live out my life in diapers and condom catheters.  Is there a better option?

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  • Posted

    My understanding is that green light (gl) vaporizes tissue where the  Holep procedure uses a homium laser which cuts tissue away. Is it possible that the strictures can be removed by the Holep procedure..If so finding a Holep urologist who can use the homium to cut the strictures away...My understanding is that Holep IS the gold standard and has long term success..not (gl) although it works.

    Best wishes to you ...

    • Posted

      Since last year GL is now the procedure recommended by NICE for  NHS patients. The hospital where I had my GL in 2004 have now switched over to HoLep

       

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