My Bipolar TURP Experience 4/5/19

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Have been active here for several years, and after considering all treatment options decided to have a bipolar TURP. My retention issues were becoming intolerable and I was spending hours in the bathroom every night trying to pee - absolutely ruining my sleep. Tried to self cath a couple of weeks ago but pain was extreme so that was not an option for me. Some here do CIC and say good things about it, but we're all different.

Pre-Op:

Was advised to go off all vitamins and supplements for the week prior. Got a call from pre-op nurse and she went over my medical history and meds. Went into the Kaiser Surgery Clinic and received a package of: ClearFast Nutrition Drink and Chlorhexidine Gluconate body wipe cloths.

Last evening did not have anything other than water after dinner. At 10pm, per instructions, showered and shampooed my hair. At 11pm wiped my body with the antibiotic cloths. Wife did my back. No itching, and the Chlorhexidine smelled fresh.

My scheduled arrival time at hospital was 6:05am, so 2 hours before, again as instructed, drank the ClearFast (18oz). Pleasant tasting, like diluted sport drink. Mostly dextrose.

Checked in at 6:05am, went to prep area about 6:30. Tried to pee twice with minor success, then changed into surgical gown. All clothes put in a bag. Wallet checked into their safe. They recommended this.

Spoke with a couple of additional nurses, and two anesthesiologists. Decided on general rather than spinal, which I have had before. My uro came by briefly.

By about 7:30 wheeled into operating room. Some chat with nurses, then woke up, and wondered when we would begin - was told it was over! I had a Foley draining into a night bag, bladder felt somewhat full and a bit irritated. They were doing the saline draining procedure. Uro came by and said the urine color looked good, and there wasn't a lot of bleeding during the operation.

They called my wife, who came to pick me up. She and a nurse helped me to stand up, and the bladder irritation subsided. I actually went home in my hospital gown with a shirt on top - didn't want to attempt to put on my pants or shoes. They give you little hospital socks.

Home by about 10:30m, sooner

than expected. Before leaving the hospital the nurse switched my drain bag to a leg bag and we secured it with tape, straps. At home I padded my underpants and applied Neosporin to increase lubrication and kill bacteria.

Absolutely no prostate pain. Where the Foley inserts into the tip of the penis there is irritation. I have experienced this five years ago when I had Foleys in and out for five weeks after radiation for prostate cancer, so I am "sort of" used to the irritation. It gets better. Took a Tylenol and that helped.

Now been home for 4 hours and urine stream is still pink, but appears to be clearing. Continue to drink water. I empty the bag into my urine measuring beaker, and an hour ago emptied 400ml - that's 1 hour! So, the hospital pumped water into me, and I have been drinking at home, not concerned about retention because of the Foley,

They did give me an antibiotic at the hospital - don't know which one but not Cipro. Also, I believe they gave me something to constipate me, because I am unable to make that happen. Normally, I go in the morning, so I feel a bit blocked up.

There is some blood coming from the penis tip where the catheter inserts, but not much in the urine stream, so that is doing well. That nagging urge to pee is, at least for now, gone away, as my bladder is continuously empty.

I was told to keep the Foley in for 3 days. I know how to remove my own, and will do so on Monday morning, then we will see how I am doing. I was told that if the Foley drain tube gets blocked by a clot I could manually rub the clot and it should then pass. In a worst case scenario there is always the ER, but so far , so good with the Foley. More later....

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  • Posted

    Glad to hear it went well, Tom. A couple of questions:

    1. 'At home I padded my underpants and applied Neosporin to increase lubrication and kill bacteria.' Do you mean that you're wearing something like Depends for possible temporary incontinence or leaking around the penis from the Foley, or.... The Neosporin was applied where?
    2. Do you have to take the antibiotics for a specific time period? If so, can you tell us which one they prescribed?
    3. With regards to the Foley blocking up, what do you mean by "I could manually rub the clot and it should then pass'.

    Definitely keep us informed of your progress.

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    • Posted

      1. I just wear normal underpants (briefs), and pad them with a soft tissue, and the penis sits on its side horizontally so there will be little tugging or movement. This reduces both irritation and bleeding from the penis tip. Neosporin applied to the Foley drain tube helps to lubricate and sterilize the tube. Also, lubricating gel like Surgilube works as well, as long as it's also antibiotic. Any gel that is used to self cath should be OK to apply to the tube.

      2. The doctors did NOT prescribe antibiotics. They gave me a shot in the hospital. The same thing happened when I got my 12 core prostate biopsies for my prostate cancer (2013 and 2014).

      3. I was told by the nurse that if the urine stopped flowing into the leg bag, the there might be a clot in the flow and I should be able to see it in the tube - so she said to just crush the clot with my fingers and the urine would begin to flow again. Never thought of that before. Good advice from her.

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  • Posted

    Good report. Sounds like it went well and hope your recovery is swift.

    How different from a UK procedure. I did all that washing etc. before heart surgery but for prostate just went in each time and they did it and have never heard of Clear Fast or anything like that for any surgery here.

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  • Posted

    Thanks for sharing, Tom. You chose one of the best procedures. Congratulations !

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    • Posted

      Hank,

      Just read my post again - now, a few hours alter, I am feeling like I have to pee, even though my bladder is, technically, empty. So, the bladder is going through a cycle of irritation. Also, I am experiencing some constipation. I believe some of the meds I got this morning cause this, but I will research more. My concern for this evening is getting some sleep. Last night, before the operation, I might have slept 2-3 hours. Who knows about tonight with the bladder irritation, the Foley and the constipation. My wife is getting me some MiraLax.

      Also, I can't think of any procedure that doesn't cause some level of prostate irritation post-op, even PAE. Had irritation and some swelling for a couple of weeks after. At least with this TURP (also HOLEP), prostate tissue is removed, so any swelling should be short lived.

      Most of the men on this forum are concerned with the possible sexual side effects of TURP, but in my case, my "cure" for prostate cancer wiped out sex issue, so now all I am dreaming of (no pun intended) is to get a good night's sleep.

      What was your experience in the day 1-3 period after your operation? Were you better or worse than you were in the days before the op?

      Tom

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    • Posted

      Tom, I have not had any procedure yet, just learning from reading trialed data results and forum testimonies. I so far conclude that my choices are HoLeP, bipolar TuRP, or GL. Right now I am self cathing and trying to gather courage to take the jump.

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    • Posted

      Hank:

      It seems to me that HOLEP and GL are fairly similar with the big exception being that with HOLEP they can test the removed prostate for prostate cancer, whereas with GL they can't. Any other differences that you are aware of?

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    • Posted

      rde, GL is good. But Holep is better in almost everything, including success rate, long-term durability, improvement in urine flow, improvement in retention. The drawback of Holep is it's more difficult to do, so it's tougher to find a uro to do it.

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  • Posted

    Happy to hear it's going well so far. It's interesting to read of the different approaches from different doctors.

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  • Posted

    Good evening Tom

    I hope all will works out for you never was a fan of any Turp procedure but with your having retention and other problems you have limited option.

    Did you doctor explain everything to you about what could happen and what should happen. I wish you the best and a quick recovery.

    God Bless...Ken

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    • Posted

      Ken,

      Uro said that because of my prior radiation there was about a 1% chance of some incontinence (which I already have), and a possibility of urethral stricture (scarring). Chances are very low. After reading about all of the other procedures here they ALL have a certain statistical probability of side effects. I am not at all concerned with retro, since my sex life went away after my radiation. What I am primarily concerned with is getting some sleep. Now, what is more important, sleep or sex? Sleep is critical, sex is optional. Anyway, since I wrote the post my bladder irritation is back a bit despite the urine flowing into the leg bag. Last night, before the operation I may have had 2-3 hours sleep, both bladder retention and anticipation anxiety. While I was lying on the prep table I asked myself if I really wanted to do this, and considering the alternatives and the increasing lack of sleep, I had no choice. Just do it. The next couple of days will be tough, then the Foley comes out on Monday, and we will see if I can pee. If not, another Foley will have to be put in. The blood in my urine is improving, but the urine is still a bit pink. This may continue for a couple of days, but the color looks better than it did this morning. I just have to keep movement to a minimum, and walk around the house slowly and not have the Foley drain tube irritate the penis and bladder. I went through this before with the prostate radiation, but didn't have to deal with blood in the urine, a bit scary. But, think of REZUM and FLA and Urolift - they all require a Foley and there is blood in the urine and prostate swelling for a period of time. With HOLEP you are kept in the hospital for a day or two. I was checking in at 6:05 am and went home about 10:30am. Very happy about that.

      Tom

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    • Posted

      Well Tom

      Deal with what you have had do over the last few years I just hope you did your research. What did your doctor tell you about your retention. We have had other men on here that were told that there is a 50/50 chance that the procedure will not cure there retention.

      We did have some men try other procedure and other said no and went on to do CIC which all men have the right to have the procedure that they feel will do the best for them.

      Yes all procedure have some bleeding because what is done . Did you doctor tell you how much of the prostate they did get rid of and did they do anything to the bladder neck. Sometime that works but it can cause you the leaking.

      I have read up on prostate cancer and radiation can do a number on the body. Yes I feel that a catheter is needed for any procedure because of the swelling. That is why I asked for mine when I had my Urolift 4 year ago. I did some research on it before and there were to many men having the procedure and they would be able to pee right after. But when they went home they had a problem and ended up in the ER to have a catheter anyway

      For me that was the first time I had one. It was fine I went home a hour after I woke up and went shopping in the evening.

      I do hope for the best for you. And you can get that sleep you are looking for.

      Sweet dreams my friend.....Ken

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    • Posted

      Ken,

      I would have preferred to do CIC but when I tried it the pain was just too great. Absolute failure. About five years ago I was able to do it a few times in an emergency, but had to take a couple of Tylenol capsules before and it was really tough. Others here seem to be OK with it, like it's "no big deal". Apparently, not for me. I think my urinary lining is just too sensitive.

      In my case, since I was unable to self cath, I had to do something fast. Just couldn't sleep much anymore - constant bladder irritation. Up 10-30 minutes every 1.5 hours at night trying to pee. I could tell the situation was becoming critical.

      Will see what happens after I get through the next few days and the bleeding stops. Urine was pink earlier today, now darker orange as the bleeding is improving, but bladder still feels irritated.

      Don't know how things will go tonight....

      Tom

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    • Posted

      Ken,

      My uro doesn't say much. Everyone agrees he's a great surgeon, but I have had to come here to research various issues and possibilities. I think my uro is very busy and seems to get irritated with me when I email him too often.

      tom

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    • Posted

      Tom

      What you need to do is lay down and relax and try not to think about it....HA HA. I know that's hard but sometime you just have to laugh to get by.

      You have been through a lot. At least the Turp you had there less bleeding. I have done CIC once in a while. Most of the time it goes through but I have a tight external sphincter. Prostate still open but you never know when something else goes.

      You did what you had to do to make life better for you. You took control or your situation. I wish more men would do that.

      Just be careful while you are walking around so you don't pull on the tube. Do that have it secure to your leg and have enough give to it.

      Take it easy hope all goes well on Monday when it come out...Ken

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    • Posted

      Tom

      That should not be he should be willing to answer your question. He may be a good surgeon but he also should be there for is patients. I would find that hard to deal with. It okay for him to do surgery on you but not taking the time to talk.

      I have a appointment next Wednesday for my Urologist. He's great I had him for over 4 years . He is only 39 and he will answer any questions I have. I made my list so I don't forget anything. Also anytime I have a problem I can e-mail him through my patient portal and he gets back to me the next day.

      His staff is very nice. And 2 of the nurses are friends of mine. His partner is a nice guy also. Well It's almost 4 am Not tired. Will be up for a while

      Try to rest. I will say a prayer for you.....................Ken

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    • Posted

      Ken,

      My uro answers my questions mostly through email, but he's not very talkative either in person or in his email responses. I would describe him as somewhat quiet and business like - no "bedside manor". However, based on what I have learned about him, and how my operation went yesterday, I would say he's an excellent surgeon, so have no issues in that regard.

      Tom

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    • Posted

      Good afternoon Tom

      I did your evening go last night. I hope you were not in to much discomfort.

      That is good but you also need a good bedside manor to go with that. I guess if he does not try to a void you. I have read sometimes that happen to some of the men on here Once the procedure was done they had a hard time getting a hold of there doctor.

      If I e-mail my doctor he get back to me within the next day sometime 2 because of his surgery schedule. When I have a appointment It's a lot of the time 10 to 15 minutes if all goes well but I have been with him for 45 minutes to a hour so he can explain it when I don't understand what he is saying. One time he even draw a picture so he could tell me what is going on. ( That was when I had my Urolift )

      I have my list ready for him. I have a 10 am appointment ( We will see ) I do not mind waiting because I know he is helping his other patients.

      Well rest up this weekend and I hope all goes well on Monday when you take the catheter out. Just be careful and if you have a problem Do go to the ER

      Ken

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    • Posted

      Ken,

      Just posted my second discussion here 24hrs post op. Was very concerned about the sleep issues last night. Was able to sleep (surprised) but did get up five times during the night to drain the leg bag. Used a combination of prayer and affirmations to talk myself back to sleep. It worked!! Doing much better this morning, urine color improving, pain of Foley much better, but may be getting a UTI. My urine test strip shows leukocytes now, and this is a sign of an infection. I am keeping the Foley insertion site well lubricated with Neosporin and antibiotic gel that is used for CIC, so I don't know where this UTI came from ( if it is a UTI). Can't get in touch with my regular doctor or uro this weekend, so any treatment or tests for the UTI will have to wait until Monday. After I remove the Foley on Monday morning, if I can't void, I will just rush over to the urology office and have a nurse put in another Foley, actually much faster than going to the ER. I could also try to self cath, but last time I tried I was unable to do it - too painful. Maybe this time it will work.

      Tom

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    • Posted

      Hey Hank

      Most of the time they do give a bed bag. I know when I had one of my procedures done at the surgery center I had the leg bag but they also give me the bed bag to use at night because I was going to have it out in 3 days.

      But when I was sent home from the hospital that did not happen. I only had the leg bag. They do not hold much. Especially if you are peeing a lot. I guess they got to much to do in the hospital and you have to ask. I had it for 10 day that time. That was when my bladder was inflamed.

      I guess we live and learn.......Have a good day....Ken

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    • Posted

      Tom

      A UTI can happen any time no matter how clean everything is. Glad your doing good today. Did they tell you what time to take it out. I would wait till 10 or 11 to see if your okay this way if anything happen you can get to the office.

      Have a good evening........Ken

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    • Posted

      Ken,

      I was thinking exactly the same thing - wait until 10 or 11am. The nurse said to take out the Foley at 8-9 am, then my appointment is for 2pm. That's a lot of time if I am not able to pee. I would then have to go to their office and request an emergency Foley ASAP. Did that once before and I was able to get in to see a nurse.

      Tom

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    • Posted

      Hank,

      I do have a night bag, but didn't need to use it. I was getting up frequently on my own and have been doing so for a long time, so the leg bag was only half full at most. IF I was able to sleep through the night, then I would definitely have to use the night bag, and as you said, it has a much higher capacity.

      Tom

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    • Posted

      Tom

      I would say early morning if you had a morning appointment That almost 6 hours If you are going to have a problem it will most likely be within the first hour. Your bladder is going to be in trauma when that catheter come out. Not saying anything about the spasms.

      I have to ask. Why do they want you to take it out. Why can't they do that at the office.

      When I had my catheter taking out I went to the office and they put in 250 cc of saline in my bladder to see if I could pee. As soon as she undid the balloon. I shot the catheter across the room what a mess plus I did 300 cc in the bottle.

      I do not know if your ready But I would get pads. It is good idea to ware one the first couple of days for any dripping or if you can't get to a bathroom It will protect your pants.

      I was glad I did. I never had a catheter before so I did not know what to expect from it.. It good to be ready for anything.......Ken

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    • Posted

      Ken,

      In 2014 I had six Foleys put in and taken out until I could pee on my own again. They called this a voiding test. When the nurse took out the Foleys she was rather aggressive and there was some pain. So, I read up on how to take out the Foley on my own in the shower. Much easier and no pain - just a little tingling. I agree that if I take out the Foley at 9am and my appointment isn't until 2pm and I am unable to pee, that could become a huge issue.

      Tom

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    • Posted

      I had a Foley put in for a week in June 2018 for retention. They wanted me to remove it myself at home a week later at 9AM, then go in for my appointment at 1PM. I figure they have you remove it yourself to save office time, or they might have also wanted me to be ready to do their flow test by the time I arrived at 1PM.

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