Prostate remnants in urine after treatment

What did it look like. After GL I had some blood clots and a few scabs but that was it. I mostly peed into a plastic jug to measure my output and look for anything strange.

Some blood clots, but a lot of stringy looking pieces, some 1/2 -1 inch long.

It could be that some debris is from the urethra.

So does the urethra regrow after TURP or GL or any other procedure that enters that way? Decimating the urethra never gets much attention but seems like it would be a major change in one's innards.

Yes, indeed, it could also be urethral debris. I was merely trying to clarify to ProstatePete that it is a single vessel, and not two separate systems as he seemed to think, judging by his initial post.

As far as I know there is water flowing continuously throughout the surgery site and later during withdrawal of the scope, and the urethra has to be penetrated just to gain access to the prostate.

Warm regards, alan86734.

Thank you Alan for that explanation. I knew there was only one pathway out of the penis (urethra) but couldn't figure out how prostate debris was getting past the sphincters (valves) Apparently any treatment that damages those sphincters will allow prostate debris into the bladder and then urethra.

"So, the pieces of prostate are passed into the bladder as a temporary measure until they are moved out again as this is is emptied."

How can prostate pieces get into the bladder? The only way I can see this happening is if the urethra being surrounded by the prostate is removed. Even then, I'd think that the urine being released from the bladder would flush prostate pieces out of the body; the prostate pieces would not migrate "upstream" into the bladder.

Hi, WilliamUSA,

A few months back I was reading up on TURP procedures and during the resection process the surgeon stuffs the entire prostate up into the bladder before removing it. I guess it is up to the surgeon to chose the particular technique that will be applied.

If it is important to you, or anyone else following this thread, I would be willing to try to track the article down. However, I cannot guarantee success. As some of us already know, it can be notoriously difficult to find a specific item in "Patient", and secondly I am not a doctor.

Drop me a line if you want me to do this. In the meantime I send you warm regards, alan86734.

Youtube has videos of all the procedures and some are done as demonstrations with explanations.

Alan,

If there is one thing that I wouldn't want, it would be to have my prostate stuffed up into my bladder! Ouch!

I didn't think the TURP could be so violent as to blow prostate pieces back up into the bladder. Even if this does happen, it can only occur with procedures that remove the urethra in the vicinity of the prostate like a TURP or some sort of laser procedure. If the urethra remains intact, as it does during a PAE and Rezum, I don't think that there is a pathway for prostate remnants to enter the urine stream.

If material is in the urine after Rezum, I'd say that it would be from issues in the urethra due to irritation from the instruments. With a PAE, I don't think that there can be any material in the urine.

Can anyone who has had a PAE contradict my hypothesis?

Thanks, and have a great day,

Bill

If material is in the urine after Rezum, I'd say that it would be from issues in the urethra due to irritation from the instruments.

I disagree. The stuff I was peeing was not from the urethra. Bill have you had Rezum done?

A few months back I was reading up on TURP procedures and during the resection process the surgeon stuffs the entire prostate up into the bladder before removing it. I guess it is up to the surgeon to chose the particular technique that will be applied.

Where did you read this nonsense? Certainly not in any medical publication.

During a regular (as opposed to button) TURP, the resecting instrument removes small pieces of the prostate with each stroke. These chunks are flushed into the bladder and then out of the bladder via a catheter. The prostate isn't "stuffed" anywhere, nor it is removed in its entirety. There are plenty of doctor produced YouTube videos on the TURP process which explain how it's done.

Yes, Tim, I had Rezum done two years ago this coming May. I never had any solid particles in my urine. The only thing out of the ordinary was blood in my semen out to about 45 days after the procedure. After this time, everything was fine.

Viewing schematics of the bladder, prostate, and urethra, it appears that these body parts are separated by walls that define the boundary of the organ, gland, or structure. Unless these walls are somehow removed, I don't see how any prostate pieces can get to the bladder or urethra.

I'd be surprised if the pin pricks associated with Rezum enable prostate pieces to get into the urethra and the urine stream. Let me know if I have overlooked anything; I've been surprised before.

Bill

The muscles of the prostate gland help propel seminal fluid into the urethra, so obviously there is an opening for this. Since the blood was only at the beginning, I'm assuming the swollen prostate was getting rid of the dead tissue and blood through this opening between pee cycles.

Since I'm not a Dr, this is just my logical explanation.

I really didn't want to think this hard about it, Tim. I just wanted to pee.

In any case, I checked into the structure of the prostate. My friend the Internet tells me: "The prostate gland is a conglomerate of tubular or sac-like glands that secrete fluids into the urethra and ejaculatory ducts." The prostate gland is thus comprised of many exocrine glands that get fluids into the urethra.

The key word is 'fluids.' I can understand that the urethra wall may be permeable to fluids such as blood or seminal fluid. If the urethra wall is intact, I still can't see how dead prostate pieces can enter the urine stream.

One thing my little study did do was give me a deeper appreciation of how intricate our bodies are. Doctors know and can do a lot. But when the basic design is altered by any kind of medication or physical change to the body, unexpected and unwanted consequences can occur. This is probably why there are such a range of outcomes to BPH treatments. We are all fearfully and wonderfully made, but are fearfully and wonderfully different.

All the best,

Bill

Hi Bill,

If you have "cutting" surgery on the prostate the bladder is filled with saline solution. In my case FlowFusor 0.9% sodium chloride. The flow is into the bladder and takes away the debris from the surgery. This is then expelled during surgery and afterwards. It's all a matter of fluid pressure. The idea is that the surgeon can see what he/she is doing. Bits of flesh are flushed out of the way into the bladder so the surgeon can see what's going on. There are two "pipes" for want of a better word, one in and one out. The surgeon's pipe flows in so the surgeon can see what's there and what needs to be cut away. The other pipe sucks away the debris from the bladder. The surgeon does not see this happening. All the surgeon sees is an inward flow taking bits away from what he/she can see into the bladder. This flow is hardly noticeable because it is regulated by the surgeon's team. All the bits flushed out are sent for biopsy just to make sure that everything is benign. Easy peasy.

Thanks, Grunthos. You provide a good picture of what goes on during prostate cutting surgeries. Do you have any insight as to how prostate material can exit in the urine stream after a PAE or Rezum procedure?

No

William,

A PAE doesn't cut the prostate - tiny beads are inserted into the arteries that supply blood to the prostate and the tissue gradually dies off. You need to read up on how the PAE is done. There is no material that gets into the urine.

Tom

I agree about the PAE, Tom.

I also don't think prostate tissue can get into the urine stream after the Rezum procedure, but some think that it can. If I'm wrong and a Rezum can produce prostate debris in the urine, I'd like to learn how this happens. Knowledge is power.

Bill

There have been several guys that said they saw pieces of prostate in the urine after Rezum and I thought I've seen guys say the same thing after PAE but not real sure about that. How this happens was my original question and in the case of Rezum and PAE it really hasn't been answered yet so thank you William for keeping this discussion open.

It's quite feasible that the pieces are from the urethra if the urethra has been traumatised in any way. I would imagine a rigid, rather than flexible, cystoscope is used for all prostate ops and so this may cause slight trauma. Any catheter inserted after the op could also be the culprit.

I guess I'm confused. I don't know about Rezum or PAE but it seems to me if you have TURP or GL I don't know how one would NOT get pieces of it in the urinary tract. Surgeons have to go through the urethra to get to the prostate. So, I assume until the integrity of the urethra is healed, the tube transfering the urine out of the body might have some residue for a time.

Bill,

When I was in my twenties, the doctor performed a DRE on me and forced prostate fluid out of my penis so it could be examined. Not much of a stretch to think a swollen prostate after a procedure could do the same, but I guess your still not convinced. To see is to believe I guess

As I understand the nature of the prostate gland, it is very reasonable that FLUID can pass from the prostate to the urethra and then out of body.

It is also understandable that bits of the urethra that has been traumatized pass from the body in the urine stream as Grunthos has said. It is also reasonable to think that men who have had a Rezum and experienced material leaving their body would think this urethra material was from the prostate.

My question remains about the pathway for solid material to get into the urine stream after Rezum or, in my estimation even more unlikely, after a PAE. Someone, please explain how this could happen!

Yes Keith I understand how prostate pieces end up in the urine after TURP or GL but still don't see how that can happen with Rezum or PAE.