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I had a TURP on 2/20/2019. Here's is some background data: 70 years old, BMI 21.6, BPH symptoms for 7 or 8 years and bladder spasms for almost 20 years. On doxazosin for 5 or 6 years (gave me retro-no big deal). Prostate not large (urologist est. 50g from the DRE) but with a large median lobe protruding into my bladder. Flow was poor and PVR was 60ml. I generally get up twice per night unless I drank a lot after dinner. Daytime frequency was my biggest complaint which made traveling sometimes inconvenient. I rarely passed up a chance to use the restroom! I had two prior transurethral surgeries to remove bladder tumors (one cancerous, one not). In the last 18 months, I have had a prostate biopsy (negative) and 4 cystoscopies and none caused me any undue discomfort. Despite this, I consider myself to be in pretty good health!
After doing a considerable amount of research, I decided I was more comfortable sticking with my regular urologist (30 years experience) than traveling to someone who does a different procedure that may or may not produce better results. My doctor uses what I believe is the currently popular version of the TURP, i.e., bipolar (in saline), loop electrode to start and then a plasma button to smooth out the surface and cauterize any bleeders. The surgery was scheduled for 1:45 pm.
Day 0 (Wednesday)
Awoke at 5:15 am so I could eat breakfast before the 8 hour pre-surgery fast. Checked into the hospital at 11:45 and by 12:15 or so I was in a gown in the pre-op room with an IV in my right hand. Since I had a slight cold the anesthesiologist wanted a white blood cell reading so I got stuck in the left arm. WBC and temp were normal. They gave me 2 Tylenols, not sure why. At 2:00 the surgical nurse came to get me. She said she would inject some Versed into my line to relax me. That's the last thing I remember until I woke up in recovery at 3:30. CBI (continuous bladder irrigation) was underway via a 3-way catheter and they drained 1000-1300 ml of cranberry juice-colored fluid every hour or so. The doctor told me everything went well. I was wheeled into my room for the overnight stay about 4:45. They checked my vitals (BP, pulse, temperature) every hour when they emptied the catheter bag. I had occasional bladder spasms but they never last more than a minute or two. After my wife left, I ate dinner and watched TV. At 11, they did the last hourly check of the vitals and said they would go to 4 hour intervals. At 11:45, I turned off the TV and the lights for the night. Still awake at 12:15 am, I asked for sleeping pill and that worked. No pain whatsoever.
Day 1 (Thursday)
They woke me a 4:00 a.m. to check my vitals but I was able to fall back asleep until about 7. Had some breakfast and watched TV. At 8:30, the nurse clamped the catheter outflow, instilled 300ml into my bladder, let the water out of the balloon and pulled out the catheter. It stung but only lasted a second or two. I started drinking lots of water. About 10, I voided about 25ml into a measurement container. It stung quite a bit and felt like I was squeezing the cranberry-colored urine through a small opening. Over the next few hours, I voided several times, never more than 60ml. The doctor came by around 1 pm, said everything was normal and I would experience frequency, urgency and red or pink urine for a couple weeks. He recommended Azo for the burning. He discharged me and said he would see me in 2 weeks. Called my wife to pick me up and finally exited the hospital at about 2:30. Got a warm hug from the attractive 50-something day nurse that made a nice end to my stay.
Day 2 (Friday)
I got up 8 times during the night but voided only a little each time. The bladder spasms woke me up. I have been on oxybutinen for 15+ years for bladder spasms but these are too strong for the medicine to suppress. Still feels like I'm having to pee through a small orifice. I'm sure everything is still a little swollen. The Azo is working and the burning is greatly reduced. Turns the pee a very bright yellow. I get a little reddish-yellow ooze out the urethra after I finish so I'm wrapping some toilet paper around the tip to keep my underwear (relatively) clean. Drinking more than usual and therefore voiding more than usual.
Day 3 (Saturday)
Got up 3 times last night which is just once more than usual. Bladder spasms have subsided a lot. If I wait too long to void, the spasms get very strong and I run to the bathroom. Flow still slow and pee bright yellow (from the Azo). Went to a concert Saturday night and was 1 hour 45 minutes between bathroom visits. That resulted in the first visible blood in about 24 hours.
This is the end of part 1. I will start part 2 in a couple days when I have more to report.
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