Post GreenLight Laser Surgery Recovery

For me- flow definitely improved. Try fighting the urges during the day.

That seemed to help only in day. I have some bad nights (once in a while every hour on the hour). A good night is 3X. No incontinence issues before or after, It seems that all of us may be in a small percentage of unsucessful results in some form or other. We have to remember the sucessful rate may be huge with other sufferers  in comparrison since people with the sucess rate probably don't post. (just a thought).

My Dr. said that 98% of his GL are sucesses. I am part of the 2%.

I decided to live with the peeing through the night (I tried Ambien so as to feel the urge with no results) because all else as far as urinary health is fine.

The nightly trips are acceptable, I agree. The semi-incontinence is not. I do not want to look forward to wearing pads at 68.

Had the GL in Nov. Bleeding for 4-5 weeks. That's the normal per Dr.

Pain subsided slowly over a few weeks. Then just a strange sensation at the start of the flow. That also subsided after 2 months or so (but no pain with it).  Sediment still occurs slightly after all this time (very little over time).

My days aren't too bad now (I try to resist and ithe urges go away. It seems to be working  that way for me). BUT...I'm still very unhappy with night time. Who could resist urges when you are trying to sleep. For some A good night for me is 3X)-which is still not what I was hoping for and for instance sometimes bad nights (5X). I don't understand the reason.

No difference in my routine before bed.

My Dr. then tried medication and med combos. It didn't help.

It does take time normally (so my Dr. said) 98% sucess(I must be in the 2%)...so hang in there. Your're doing fine so far-post surgery.

Hope you have better results. My Dr. was miffed about the frequency and referred me to an associate. I am going to live with the frequent night visits for the time being rather than start the process over again.

Good luck.

I've had 2 GL's and a Turp in 4 years and although these procedures can increase flow and reduce the PVR, they did not stop me from getting up at night. The best I ever achieved was 2x per night. Now I am taking heart meds and diuretics so 5x a night is normal for me. The problem with expecting a GL or Turp to cure nocturia is that it will only do so if the only reason for getting up at night is the prostate. But for many people, the bladder, being in a reclining position, or other factors control the night time urinations, even if the prostate obstruction is removed. Welcome to the 2%. I use a bedside urinal, pee in the dark while sitting on the edge of my bed, and get back to sleep in minutes.

After my three procedures the urologist gave me a prescription for a percoset. In hospital I got hydrocodone tablets for pain. I only used them for a short time ( think I used about 10 tablets each time, but they will take the edge of any pain for about 5-6 hours for me. The only downside is constipation, but 2 Senekot tablets at bedtime sorted that out.

It is not normal. GL is supposed to be day surgey and back to normality in a couple of days. People who post here are the ones who have  problems and I really do not understand why. It is a tried and tested procedure that has been around for over twelve years.

GL is now the preferred procedure by NICE in the UK.

It is mostly American posters who have problems. What is the problem with your urologists?

Sorry for the rant but I just do not understand why so many of you have weeks months of problems. More even than I would

expect from TURP.

 

derek76-

You have to understand that the sucessful GL surgerys don't have a need to use this site. As I stated 98% GL have been proven to be sucessful (I don't know to what degree). It is usually the patients who have complications that post. If you go on this site  prior to GL surgery it would scare the hell out of you. And yes- it is NORMAL to bleed and have pain (to a degree). IT IS INVASIVE! The Dr. will or should tell you this.

 

One more thing-. You are right....A healthy active person should be up and about within 2 days (but blood & initial pain with flow). I ran in a race a week later (probably not advised -but I was fine)

Exactly and that is the vast majority. The failures then try to put off newcomers. I stick around to try to counteract that and bring reason to the Forum. Honestly in my two procedures GL and Thulium/ Holmium when it regrew I had no pain. Invasive yes but as the uro who did mine once said it is a 'gentle procedure' when talking of doing the procedure on a 92 year old in poor health and with a very big prostate.

I had some bleeding after the Thulium laser one that would have stopped on day two but the NHS in their rush to be rid of me sent me home with a catheter in place and that delayed recovery.

Back in the days of News Groups the early GL/PVP posters raved about their sucess and one friend of mine was having sex by day four.

I sometimes wonder how good some American Uro's are? Are they just running money making factories.

One of the UK's top Uro's told me that initially they thought it was a simple procedure but later realised that it needed to be done with more care.

I was supposed to travel home by train on day two but as I was not fully voiding they kept me for a second night in case I had a problem. On day three I went to the races and on day four or five had to walk a few miles to a dermatology appointment as there was a bus strike.

I was only my Uro's eighth patient and I had no concerns about that.  

Derek, how old are you?

You are right...

I begin to think that a lot depends on the age of the patient. I am 76 and frankly have no hope. Either you are cured during the first 3 months or you are not. I haven't spotted anybody yet who was cured from nocturia, let alone incontinence. Have you?

I will be 82 next month. I had GL in 2005 when my prostate was 75grms and the the Thulium in 2013 when it had regrown to 135grms. 

In 1994 my prostate was said to be 35 grms and I was told that I needed a TURP as a matter of some urgency. I said NO and waited for developments in laser surgery that did not reach the UK until 2004.

If starting out now I would opt for PAE.

No incontinence of any kind? Lucky man...I am still having this overflow incontinence at night and I doubt it will ever stop. I was to be treated by gL, but they had to turn to TURP during the procedure because of the cancerous cells (so they said). I was up and around very quickly, the incontinence started later and so far nobody knows why. I have this cancer, but can this be a cause? Do you think I should try PAE as a second procedure? Thanks for your post! Zdzislaw

No incontinence at all, no urgency, no retention and PSA down to 0.74. I still get up twice  in the night but to a degree that is because I don't sleep well for other reasons. My only complaint after each procedure is that my flow is not as good as I expected. When I went for checkup after the GL another patient there said the same. I've had a couple of cystoscopies that did not show any reason for it apart from perhaps the bladder having stretched due to years of retention.

Possiblty the cancer is the reason but what did your surgeon say?

How do they see the cancerous cells when the GL is buring tissue away with nothing saved. With my Thulium/Holmium procedure one laser cut 37 grms of tissue away for testing and the other burnt the rest away.  

 

You ask the question that I desperately need an answer to.  I have been totally incontinent since  a Green Laser TURP procedure on March 10, followed by a Gyrus TURP procedure on May 13 that was to clean-up debris and inflammation from the first procedure, and hopefully restore me to at least some degree of continence.  I am now over 5 months from the GL procedure and over 3 months from the Gyrus procedure, and I am soaking pads and diapers 24 hours per day.  I even get up in the middle of most nights to wash up and change.

Just today I read a report authored by Drogo K Montague of the Department of Urology at the Cleveland (OH, US) Clinic.  The title of the report is "Artificial Urinary Sphincter: Long-Term Results and Patient Satisfaction."    In this report, Drogo references a 1989 study involving 3,885 TURP patients from 11 different institutions.  For this group of 3,885, only 0.5% reported incontinence being a problem two months following the TURP procedure.  Unfortunately, I can't access the 1989 study to see if that 0.5% (i.e. about 18 men) who still had any significant incontinence after two months ever "got better."   

I have been told that at my doctor's practice, they don't want to talk about surgery for an artifical sphincter until after a year of waiting for improvement.  (Make that a year of suffering!)   I suspect that the number of cases of acute incontinence following TURP is so low that there is no longitudinal study of what percentage get better after 6 months, 9 months or 12months, and never.

I have been doing physical therapy directed by the Urology practice's PT staff for about 3 months now; I also use an electrical stimulation device for 30 minutes, twice daily, to improve the pelvic floor strength. I pay out of pocket for the PT and for the rental of electrical device, new batteries every week, pads, diapers, etc.  I'm sure my incontinence related espenses for the last 5 months are easily over $1,000 by now.  But, the money is not the main issue, it's my quality of life which is no better than 20% of what it was when I agreed to have TURP surgery.

Glenn,

Have you considered using an external male catheter instead of the pads? I used super absorbant diapers for a short while at night and had to get up in the middle of the night to wash as well. I didn't consider them a good option. The external male caths come in a variety of styles, with and without adhesive. I'd be leery of adhesive as it might start to chaff after a while. But the looser external caths are gravity fed to a leg bag or a large night bag on the floor. You might have to tilt the top of your bed up to avoid splash back or sleep in a recliner chair, or put some sort of packing at the top of the cath. But I believe it would be a better solution than wet pads and diapers 24x7.

If you google external male catheters one of the sites near the top is lo cost medical supply (one word) that has more than 50 models of external caths at low cost.

Bob

Thanks Bob.  I have used the coloplast external cathethers on a few occasions.  The physical therapists I see tell me not to use them or a cunningham clamp as they believe they interfer with bladder retraining.   I did have a problem once when I sat in a recliner with the leg bag on and fell asleep for awhile.  I had reused a bag, although I had flushed it out, but I think the bag was slightly elevated.  A few days later, I developed a UTI, the first and only one that I've had in my 77 years.  I think the elevated postion allow some urine back flow.

  While the external catheter does help in that allows part of my anatomy to be dry for awhile, I find that keeping the bag on my leg while walking around is not too much fun after a while.    

I am currently spending

I am currently trying to find a urologist in the  who has a good reputation for doing  artificial spinchter emplacement procedures.  I just don't see any improvement for myself, and suspect there was some injury to the sphincter during one of the two procedures that my doctor is not telling me about.

Glenn,

Good luck with your research and finding a solution to this problem. If you have had no improvement after months of PT, then it doesn't seem that it is doing much good. Maybe you can find postings of people using the artificial sphincter to get a feel for what their experiences are.

Bob

I am at exactly the same point, only they haven't started experimenting on me yet....

I agree!!!!

I had my GL completed with TURP....

I found one person in FL through a friend, outside of this board, who existed for 2 1/2 years with a high level of incontinence after TURP.  He finally had the artificial sphincter done at the Mayo Clinic.  He is very satisfied and said he "would have it done again in a heartbeat."   He does wear a light pad to handle a few drips during the course of a day. 

I know my condition is rare, affecting only about 0.5% of patients after two months following TURP, but that doesn't make me feel any better.  So I'm apparently obligated to live for another 6.5 months with what seems to be a fruitless PT program before they will even talk about the artifical sphincter.  I've read a Harvard document that reviewed a number of study results about the efficacy of Kegel PT for men.  Their conclusion is that the results are ambiguous for men.   (For women,  studies show a demonstrated value for Kegel exercises for incontinence.)

Hi Glenn,

If you can find out who did the artificial sphincter on the poster, why not contact the Dr. about your problem? Most insurance plans no longer require a a referral. If the Dr. at Mayo says you need to wait a year then you do. But maybe he won't.

Bob

Thanks Bob, that's an option I may consider.  I have three university teaching hospitals within an hour of me, and I'm trying to find something there too.  Or, i may have to fly to Jacksonville where that contact had his surgery done.  I appreciate your suggestioin.

Hi David,

?    I'm to have the GL in several wks. Would you be kind enought to share how you're doing & how fast you resumed running & all other activities. I'm race most weekends & bike most every day. Thanks again for any advice you can share. Thanks, Ronnie

I am or was a runner but I had GL 4 months ago and I can't run 50 feet without a terrible urge to pee. Last time I tried was a month ago and I stopped 13 times in 10 miles to pee. Most of those times were dribbles or nothing at all. I have to drink a lot of water each day so as to have something to come out when I have the urge to pee. If I don't, I still have the urge to go but only very little comes out or just dribbles. Running is my therapy so this is not good ! Last night I got up to pee 7 times, had good flow and lots of urine, went right back to sleep but still tiring ! Has anyone else had a problem with getting back to running after GL ? Thx

When the bladder has been pushing through an obstruction for many years, the walls become hypertrophic (thick). Thus, reducing its holding capacity and ability to stretch. This causes frequent urination because the bladder has a small capacity. Of course, I assume that you don't suffer from a heart or kidney condition that makes your legs and feet swell. When this happens, the fluid from your swelling becomes urine during the night. Reducing fluids intake after 6 pm may help.