Pre & Post GreenLight Laser Surgery Journal

Pre and Post GreenLight Laser Surgery Journal 

History:  I have a moderately enlarged prostate and have needed to get up at night to use the bathroom for years. During the last five years the frequency has gradually increased to 3-4 times per night. I tried Flomax for fourteen weeks just over a year ago but it did not seem to help so I stopped taking it. Recently, my bladder filled up and for the second time and I was not able to get enough of a flow to empty my bladder. Below is my journal…

It is Monday morning and it has been four days since I have voided with my normal stream. For four days and nights I have only been able to urinate a small amount every time I have the urge to void. My bladder is very distended and painful. At the Urologist’s office a catheter is inserted (pretty painful) and 1½ liters is drained from my bladder. During this appointment the decision to do the GreenLight Laser (GL) surgery is 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". The urologist recommended that I leave the catheter in for a week to let the bladder recover. Since the GL surgery was scheduled for two weeks from now, it was decided to not remove the catheter until the surgery.

I learn to live with a catheter bag on my leg during the day and a large night bag for sleeping. I am not able to move around very much at night – just lay on my back or right side. Every morning and night and after showering the bags are changed and washed out. Otherwise, I am able to do almost everything I would normally do except my three mile runs.

 Two weeks after the catheter is inserted and my bladder is drained, I have the GreenLight Laser surgery under a general anesthetic and go home six hours after arriving at the hospital. This is my first ever surgery and the doctor and hospital staff are outstanding.

 Day 2:  I have been pain-free since waking up from the anesthesia yesterday at the hospital. I have a catheter in that I will remove tomorrow morning. My urine has been light pink since leaving the hospital. The only medication I am on is Cipro (in case an infection develops) and Flomax. I have a prescription for Hydrocodone (for pain) but don’t need them since I have no pain.

 Day 3:  The catheter is easily removed this morning. I have some coffee, orange juice and cereal with milk thinking it will help me start to pee on my own. Wrong. Two hours go by and my bladder is very painful. I try to relax and am hesitant to try pushing hard to pee because of the surgery. I start to have spasms as I try to pee but nothing comes out. Finally, 2½ hours after removing the catheter I am able to pee and as the stream starts there is an extreme stinging pain at the tip of my penis. For the next five days there is pain most of the time when I start to pee.

 Days 4, 5 & 6:            My urine is clear of blood and I have to pee every 30-60 minutes day and night. When I have the urge to pee, I have spasms (from my bladder?), a stream starts for just a second or two then dribbles. It is quite painful at the start. I am drinking 2 liters of water during the day and half a glass of water every time I pee during the night. ( I later discover that I probably should not have been drinking any water between 6:00 pm and the next morning.) I start taking the Hydrocodone at night hoping it will relieve the painful start of urination. It only seems to help slightly so I stop taking pain medication. For the first time in my life, I have the “sudden urge to pee” during the day and have to get to the toilet immediately.

 Day 7:   I go to a luncheon and teach a woodworking class where I volunteer. I am still peeing every 30 to 60 minutes. After being there for three hours, I begin to have pink urine and go home. Lesson learned.

 Day 8:  I call the urologist’s office with some questions regarding my recovery.           

·      Should I be drinking water day and night? No, just 2-3 liters during the day only. Stop at 6:00 pm.

·      When should I resume my normal activities? After two weeks.

·      Should I be concerned about the blood in my urine yesterday? No, I should expect occasional sloughing of scabs and bleeding from the lasered area for two to three months.

·      How long will the surgery recover take? Six to eight weeks.

·      Why is it so painful when I start to pee?  The pain is radiated from the area that is healing from the laser.

·      Will taking pain medication help improve my stream? Probably not.

·      Should I try to train my bladder by holding off urinating so often? You can try that if you are able to. You will void less frequently if you let your bladder fill more. (I later discover that the time between voiding gradually gets longer without the need for training.)

Day 9:   This morning, for the first time since the procedure, I have a strong stream, slough some scabs and have blood in my urine but no pain at the start of urination.  My urine clears through the day and the strong stream continues. It is interesting that the pain I previously had when I started to pee is now at the end of the pee.

 Day 15:   I notice that there is no longer any pain associated with peeing. My stream is very good. Since having the surgery I was always pain-free except when voiding. There is still an urgency to void but I am able to hold off at least until I get to the toilet. I am getting up between two and four times at night between 9:30 pm and 5:00 am.  During the day I can go two to three hours between trips to the bathroom which is a big improvement. (It depends how much water I drink during the day.)

Day 25:   I continue to use the bathroom less and less during the day and night. I feel great and am looking forward to my one month checkup where I hope to get the go ahead to resume my exercise regimen and get off the “no lifting” restriction.

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