Post GreenLight Laser Surgery Recovery

Evidently not in the UK from this posting on another site.

" It's my last week in London, and I think I'm coming down with a UTI. ?Before I resort to going to a walk-in clinic, though, I wanted to get some pain relievers from the pharmacy. ?In the States, I buy it over the counter--it's called Pyridium or Uristat--so I googled the actual drug name before I went to Boots, figuring it was probably called something different in the UK.

The pharmacist looked up Phenazopyridine in his huge blue book, and while many European countries have it (like Spain), there is no equivalent in the UK--not even by prescription. ?Honestly, I am shocked. ?This is the best pain reliever for UTIs, and it doesn't even exist here? ? ?

I'm taking the cystitis sachets right now, and I managed to find cranberry "juice," but ugh--I was really hoping for an analgesic instead."

I was told not to take Cranberry juice after my GL as it would cause stinging as it is acidic.

Hi, I had exactly the same thing (GL and small TURP) 4 weeks ago and I have this cystitis-like feeling plus fever 37,5 C (101 F ???) and a little blood at each pee.  Can you answer two questions: how did you deal with it and whether you worked normally at this stage. I have a long drive ahead of me (in 3 weeks). Should I postpone it?  Best regards 

I have had the surgery 2010 and since been having problems with bladder not emptying it sounds like I'm going to have it redone again 

Thank you Bob, Bart, Derek, Graham, Peter and John for sharing your experiences. I will be patient and anticipate some progress from week to week. I have started to drink half a glass of water after every pee day and night and that seems to help give me more of a stream instead of just dribbles. For those that are considering GL, here is my history. For years the joke in our family was that I had a "small bladder" because I was often looking for the bathroom when traveling. I have also needed to get up at night to use the bathroom for years. During the last five years the night frequency had gradually increased to 3-4 times. I was OK with that because I always went right back to sleep and rarely woke up my wife. 1 1/2 years ago my wife and I were out of town visiting relatives and I had four beers without using the bathroom as much as I should have. That night I got very little sleep because I was so uncomfortable with a full bladder and just could not pee it out - only dribbles. After two days of dribbling and really pushing I was able to empty my bladder and get my normal flow back. Well, 2 1/2 weeks ago history repeated itself (four beers while out of town with friends) and the same thing happened. Only this time I could not get my flow back after trying for four days so I had to be cathed at the Urologist's office where they emptied 1 1/2 liters from my bladder. It was while lying there with the catheter in that the decision to do the GL was made. My urologist had previously told me about GL and said that most of his patients say "they wish they had done the GL sooner". While my current post-surgery recovery is kind of a pain, this was a good time to have the procedure since I am pretty healthy otherwise. Also, I had tried Flomax a year ago and since it was not having an affect on my nighttime frequency, I stopped taking it after 14 weeks.

Hi Jim,

My history mirrors yours almost exactly. I found that the GL did solve the problem of retention and inability to get a decent stream. It did improve my getting up at night by about 50%. Before the GL I was getting up about 6x a night, now I average 3. Like you, I get right back to sleep. 

The bladder does become smaller after many years of pushing through an obstruction. The bladder wall is a muscle that grows thick with the exercise. It will never go back to the original size. Beer is alcohol, which irritates the bladder and the prostate, causing swelling. If the passage was already narrow, the irritation from the alcohol will close it. Once the prostate reaches a certain size, nothing will shrink it. It has to be mechanically trimmed to a smaller size. Incidentally, the remanent prostate tissue will continue to grow as you get older. I had an open partial prostatectomy 20 years ago. The residual prostatic tissue grew back, causing the same obstructive symptoms I had two decades before. Fortunately, there is green light laser nowadays. I had the procedure one week ago and I'm recovering very quickly. In comparing the two procedures, I can only say, that GL laser is a breeze. I would never go back to having the same sugery I had before. Of course, there is a convalescence period, but not as horrific as with the old method.

This is my story so far...

For many years I wake up 3 times a night (approx). to urinate.

The past year it was getting out of hand-sometimes every 1-2 hours.

My quality of life was beginning to suffer (although I usually could go right back to sleep). My urologist prescribed so many medications without any results. I was then given a cystocopy where the Dr. concluded that I was a perfect candidate for the GL procedure. (the bladder/prostrate opening needed to be opened to correct the problem). The actual procedure went well as far immediate recovery,

Stinging for a few days, blood for 3 -4 weeks or so. Sometimes heavy sometimes light usually toward the begining of the flow. I was able to do all activities after (I'm a 62yo runner) except on the Dr's advise wait till the blood stopped before returning to physical activities. I just had my 6 week followup. I told the Dr. I am not happy and depressed with the results. My flow is definitely stronger but I still get urges and have bad nights where I am still up a few times to urinate (once in a while only twice). I still have urges(not as often or bad). Often after I urinate I still feel I have to go within a minute or so again.(that was also a symptom before the GL surgery). I still have a second of discomfort when I start the stream (not stinging). The blood is completely gone (I could usually tell when there was blood by a strange smell of the urine).  At the follow up last week, The Dr. assured me and is confident that I am still healing and it will take a while. The Dr. did not tell me about the retrograde ejacutation prior to the surgery so it was quite a surprise after my first attempt. I  have not quite achieved a full orgasm  (close but no cigar). The ejaculation is a major concern. My ability to achieve an erection has not been effected at all (even the day after the surgery). My next follow up is in 3 months. So that is my experience so far. I wasn't under the impression it would take months to see results. I would appreciate anyone else who could share.

 

Hi David,

I'll start out by saying the condition of the prostate, size, symptoms, median lobe protruding into the bladder or not, condition of the bladder mouth (overgrown and restricting flow or not), possible strictures, etc. will all dictate how successful and long lasting any procedure will be. After you hear my "share" you may be sorry you asked. I apologize for this lengthy response but 5 years of dealing with this is hard to summarize.

I think urologists mostly project the best case scenario on the patients and with a GL or Turp will often say this will fix all the problems for a decade or more, but it can be very different, as it was in my case.

I'm 69 and at 64, after 20 years of frequent urination day and night I took a hard fall on my butt on the ice. A few weeks later I went into full retention and needed to be cathed in the ER. I took flomax for a few months, but in June, 2011, my uro recommended a TUMT (microwave treatment) to open the path through the prostatic urethra. The improvement was suppposed to last 5 years. My prostate at that point was 100g. as measured with an ultrasound,  with a pronounced median lobe protruding into the bladder. I had the TUMT and after 6 weeks of very painful spasms and bleeding I recovered, but in less than a year I was back in retention.

In June, 2012 my uro performed a 180 Watt GL laser procedure. Before the procedure an MRI showed my prostate was 303g.  My uro assured me my prostate was probably only about 120g. and the shape of the median lobe threw off the measurement formula which was made for an eliptical prostate rather than one that looked like a star fish with the median lobe at tthe top of the star. This GL was going to fix me up for at least a decade.

I had the laser procedure, and after 8 weeks of bleeding and eye popping pain at the end of urination, I healed. But within a couple of months I realized my stream seemed like it was going through broken pipes. A lot of urine flowed quickly, then stopped, then starting again after I leaned to the side or pushed out my stomach. 

Six months later my syptoms returned and my uro found a membrane had grown over most of  my internal sphincter at the start of the prostate. It was removed with the systoscope tool. My uro wanted to do a second GL, but after I researched it and asked if self cathing once or twice a month woiuld "keep the channel open", he agreed this was a good strategy. This was Dec. 2012.

Exactly a year later, in Dec. 2013 I started to hemorhage fresh blood from the prostate which clotted almost immediately, putting me in retention and an ambulance rushed me to the hospital. After 3 days on an irrigating catheter in the hospital I was still bleeding. In fact my Hemoglobin dropped to 5.6 and I passed out. I immediately started getting blood transfusions. My uro went in again with a  green light laser and cauterized bleeders on the prostate and bladder neck, and did a resection of the bladder neck (widening the opening) and while cleaning out large clots which covered my bladder wall, he found and removed a bunch of bladder stones (he said they were like a bunch of bb's), and shaved off some of my protruding medin lobe.  I wound up getting a total of 8 pints of whole blood transfusions before leaving the hospital with a hemoglobin of 8. After 8 weeks of spasms and pain after urinating and bleeding I healed. This time the "broken pipes" seemed to be working better, making me believe the bladder mouth resection had competed the job the firs GL had left undone.

I seemed to be doing well, no more cathing or retention, but all during this period I was still getting up 4 times a night (I still am) but that seemed better than 6 or 7 times a night so I took it. I always went right back to sleep so it wasn't big problem and I was going a couple of hours without a bathroom during the day, where before any of these procedures I had been going every half hour or so all day long, and every hour at night. So it seemed good.

10 months later in Oct, 2014, I had a sonogram and it showed my PVR (post void residual) was great down from 200ml before my second GL laser to just 25ml. My stream was great, I was only getting up 3-4 times a night and lasting 2 or more hours during the day without needing a bathroom. The only thing that was weird and which I didn't pursue because I was so elated about my improvements, was that my prostate size was measured at 313g.

In April. 2015 I had a second hemohage of the prostte with clots that sealed up my bladder and put me into painful retention. Again an ambulance took me into the hospital and I had three days on an irrigating cath. The bleeding wouldn't stop. My uro couldn't get a GL laser machine so he went in with the classic turp. He said removed about 70 g. and trimmed the median lobe to where it was no longer protruding. He sent about 35g. of tissue to pathology and it was determined there was no cancer. (I had never gotten a bipsy and the gl laser incinerates the tissue so a bipsy can't be done). By my uro's estimate my prostate was down to 40g. plus a 25g. median lobe. I went home with a cath but kept bleeding fresh blood.

Two weeks later the hemoraging started again when my uro was out of the country, so back to the hospital by ambulance and the house uro went in to clean out the clots and stop the bleeding. After 3 days of additional irrigation I left the hospital. The bleeding didn't stop until the day before I was scheduled for surgery again to stop the bleeding, two weeks later. I was scheduled for surgery on Monday morning and the bleeding stopped on it's own on Sunday afternoon. I kept the cath in for another 2 weeks.

This October I went to my uro for a six month check up. Before visiting him I asked for an rx for an ultrasound to measure my prostate and PVR. The PVR was great at 30ml., but my prostate was measured at 202g. I asked my uro what we could do. His only solution seemed to be repeated surgeries for the rest of my life.  During and after the April procedures I had gotten 6 pints of whole blood transfusions to bring my hemoglobin up to an 8. My hemoglobin was still only 11 after 6 months of recovery (normal is 13 to 15). I couldn't see going in for another surgery every couple of years.

Before my uro appointment I had researched Avodart (dutasteride) which is supposed to shrink the prostate by 25% and keep it from growing as long as you take it. This seemed preferable to repeated surgeries. I asked if this would work and my uro agreed. I have been on ther dutasteride for 5 weeks and have been feeling some new burning and dribbling at the end of my stream, but test strips show no infection, so maybe it's a side effect of the drug I'll have to live with.

During my visit I asked my uro why I got the two hematuria incidents (hemorhages) since I don't take blood thinners or aspirin type drugs. He said it's quite possibe all the procedures had weakened certain veins in the prostate. 

After this last turp I finally got retro which I had avoided with the two GL laser treatments. I didn't know I had it because my orgasms were just as good. I couldn't figure out why there was nothing to clean up. So for me the retro is no problem. 

At 69, I am in pretty decent shape, I walk, enjoy a couple of drinks before bed, enjoy retirement and have been married to the same woman for 42 years. But this fast growing prostate has left a hanging sword over my head. All I can do for now is take the dutasteride and get another sonogram in 5 months, and for now, hope for the best.

.

Only 3 weeks after the procedure. Developed pain and slight fever. Will check for UTI tomorrow. Blood at the beginning. No idea how long it will take to be better! Have you had any problems of clots?