Limited TURP Surgery Required Again
Posted , 5 users are following.
I had a limited turp surgery completed in 2017. I'm currently 48 years of age and noticed the past few months that my urine flow has been slightly weaker (but still able to urinate no problem at all). However, I also experience aches and slight discomfort in the area that I had my TURP surgery and that when I ejaculate, it can feel aching for a few hours afterwords.
I had a follow-up cystoscopy today and sure enough, prostate is enlarged again and he could barely get the scope through. He's recommending a follow-up turp surgery to resect the prostate again. My question is whether I should go through with this or wait it out longer? I'm still able to ejaculate normally so no retro grade ejaculation and I worry that it'll just come back again if I have the surgery again.
I'm also confused as to why this keeps coming back, particularly at my age. Any recommends/suggestions? I'm scheduled for the surgery next Tuesday.
0 likes, 8 replies
Allondon tom53626
Posted
My approach is very conservative and I would not be rushing into a new surgery. Having TURP every few years is not only unpleasant (to say it mildly), but does not seem to offer a long-term solution.
Have all possible blood/urine/prostate fluid tests and then MRI if they come back negative.
This will give you (and your urologist) a much better picture to make decisions.
There are newer procedures which may be more appropriate for you or you can try 6 months of finasteride/dutasteride and see the effect.
Never make life-changing decisions based on a single doctor's opinion.
tom53626 Allondon
Posted
thanks for the feedback. i have decided to post pone my surgery and see how things going over the next few months. I also want to get more informed before i decide to do another surgery. even the first time around was pleasant.
i have a follow up appointment with the urologist in a few weeks and will ask him why he is immediately suggesting another surgery and whether i am a candidate for any other options. will report back when i hear more. thanks!
Allondon tom53626
Posted
You did not say which country you are from as options are different.
All urologists learned TURP as this is the oldest method. Some of them perform 1-2 other procedures but are rarely willing to discuss all options available.
It is highly advisable to get all sorts of tests performed to exclude any inflammation or infection, followed by an MRI or , at least, an ultrasound.
The pain and discomfort may be caused by reasons other than prostate re-growing. Also, there are medications to try as a temporary solution.
If you need to have a surgery for BPH, Holep offers the longest remission. Some of the new procedures (aquablation, FLA) do not have enough history to assess long-term impact.
Good luck!
ben27324 tom53626
Posted
Tom,
what do you mean by limited Turb ?
Is it the so called ejaculation sparing Turb?
and do you know how much was resected from you prostate?
tom53626 ben27324
Posted
the urologist called it a limited turp surgery because it required a small amount to be removed i just had a repeat cystoscopy and its grown back quite a bit to the point thaf he was having a hard time getting the scope through
also, i just had my PSA levels checked and it came back at 5.2 which has be quite concerned. I'm only 48 years old and if i am already having these issues now, i worry about what the future holds
tom53626
Posted
guys, i am really struggling what to do with this. My prostate has grown back, I am 48 years old and my PSA test this week revealed a 5.2. Urologist is recommending a repeat TURP surgery.
Should i be concerned about prostate cancer and would i be best to try medications first? i just worry that waiting may result in a much more complicated situation in the future
any suggestions? symptoms right now are very manageable.
Allondon tom53626
Posted
Tom,
There are 2 questions to be answered:
Q1: Is there any chance of cancer?
The answer to the first question is MRI. If it is positive - your choice of options will be different.
Hopefully, it is negative and we are advancing to Q2: Do you plan children?
If your answer is positive - Rezum and FLA have lower probability of RE.
If it is not that important - go for Holep.
Turp, especially partial, repeated Turp, has no advantage over other procedures, except for wider availability.
At your age medications will not help you long enough to avoid surgery when you become older. They are likely to come with a long list of side-effects as well.
Don't be too worried about PSA. Large prostate or irritated prostate produces a lot of PSA, this is not a reliable cancer marker.
tom53626 Allondon
Posted
Thanks for the reply, that's very helpful. I just got off the phone with the urologist and he says my PSA level could be high because we just recently did a cystoscopy. He's having me repeat the PSA test but says it's too high for someone my age and based on the size of my prostate.
He also said that most of my issue right now is scar tissue which has really blocked the channel. He's recommending a repeat TURP and mentioned he would do it in a limited way to deal with the scar tissue and a high probability I will maintain sexual function as he doesn't feel it's necessary to make it a larger procedure than it needs to be.
However, he also mentioned that it's very likely I'll need to repeat this procedure again some time in the future. Not sure why he's so confident on this aspect of it - perhaps because he plans on taking out a limited amount this time?
Will post again once I have completed the follow-up PSA tests and see what the urologist advises.