The Urolift procedure; patient views and questions

Hi Charles, I read your info, thanks for that. I have a question? I was advised to have Turk v Grennlight. I cannot have Urolift,because of diverticula, and median lobe.Also because it would take 6 implants.Where you in complete retention? no natural void? Thats where I'm at for 1 year i do CIC. Ibelieve at 87 this surgery might not be a good idea. I would like to do the urolift,however i was told this would not work?My questions ? Could you ask your Urologist if there is a possible chance this could work?

Thank You Much?

frank,

Hello Fellow Men !

I'm TIM, retired pharmacist. I'm 66, 67 in 2 months. I'm 5'8", 165 lbs. I've had BPH for about 12 years. I take Proscar 5 mg daily....for about 11 years. Oxybutynin Extended Release 5 mg daily was Rxd 1.5 years ago.

I had a Urodynamic Study 2 years ago,results were okay. That was my first experience seeing a Urologist (2015, December).

My PCP referred me to UROLOGIST after my PSA was 4.13. Not really high, but since Proscar was being taken, both my PCP and later, Urologist stated that if on Proscar, the PSA levels are multiplied by a factor of 2, so 2 x 4.13 = 8.26, rather high, so I went back to urologist I had visited in 2015. I had a transrectal prostate biopsy done 6 weeks ago. 3 of the 12 biopsy samples were positive for cancer. The 3 samples were sent out for DNA analysis and luckily my cancer is NOT an aggressive type that is going to metastasize to other areas. I'm getting no cancer treatments. Urologist said he'll do "watchful waiting" where I'll get regular PSA levels done, as well as yearly biopsies, maybe every 6 months.......... but he said yearly is more like it.

He recommended numerous drug therapies for my urinary urgency. I had side effects of edema with 2 meds, and as expected, several others caused either ED, or retrograde ejaculation, where your ejaculate goes into your bladder, instead of out your penis. Those were not for me... I didn't like the odd feeling, unsatisfying orgasms that I experienced..... so I didn't want the Flomax (Tamsulosin), etc.

I wanted an option for my urinary urgency and incomplete bladder emptying. I never got up at night to urinate....lucky there, but I would have intense urge to urinate when I stood from a seated or lying down position. My flow was weak, I had difficulty voiding (I dribbled or had very weak stream) even though my urge to void was STRONG ! My bladder didn't empty fully either. I found if I sat on the toilet to urinate, and waited, I would urinate more, even tho I felt empty.

Long story short, Urologist discussed URO LIFT and I wanted it done ASAP. I was scheduled to get it done 2 weeks later. Done in doc's office under total anesthesia with propofol.

URO LIFT was done very quickly.... less than 20 minutes. I had 6 stents placed, as well as an indwelling catheter to go home with (not all docs do the catheter, but after reading that 30% of men who went home with no catheter had inability to void at all and had to go to ER for emergency catheterization, I was going to insist on a cath). But my Urologist said he routinely caths all of his URO LIFT patients, so I was glad.

All went well at home.... Cath was draining bloody urine into bag strapped to my leg. However, about 4 hours after being home, I noticed EXTREME burning and EXTREME urge to urinate. My cath was leaking quite a bit. I had to gently hold paper towels over my penis tip to catch the leakage. The burning and urge to urinate kept increasing rather quickly. It decreased when I laid down, so I went to bed early, and I slept on multiple towels, under which I had put 2 heavy duty black plastic garbage bags so mattress wouldn't get soaked. When I awoke in the morning. (About 19 to 20 hours post procedure), I decided to remove my catheter, as leakage has escalated to bloody urine literally spraying where the catheter and my penis met. I suspect a blood clot was blocking the flow into the cath tube..... I'll ask doc on follow up visit. Doc told me after procedure that since I was a hospital pharmacist for 18 years, he said I could remove my own catheter in the evening of the day post procedure.

I connected the empty syringe given to me by my doc, withdrew 10 ml of fluid that was in the bulb in my bladder... to keep the cath from falling out..... then I disconnected the syringe and SLOWLY pulled the 9 inches of tubing out of my urinary tract. It was actually painless to do, but I pulled it out very slowly. Once out, the leakage and spraying of bloody urine stopped. I DID have to void frequently and it was very painful each void. When I DID urinate, it was just dribbles, no stream. I felt better that the leaking cath was out !!!!. Then, later I began passing blood clots whenever I had to urinate. I took pics lol. Over Wed, Thurs, Fri, and Sat. I continued having frequent, very painful urination, with 1 or 2 clots also passed just about with every urination. The passing of the blood clots was EXTREMELY PAINFUL EACH TIME , but I thought better to pass them than to have them block my urethra. I was almost screaming at the intensity of passing each clot. The pain was a 8 to 9 out of 10 for each clot passing.

It'd have been nice if I had been told about the passing of all the clots. This was never mentioned to me !!!! I was counting the clots that passed over the 4 days that I passed them...

I lost count after 18..... as I passed numerous clots while I showered. I'd guess I passed around 25 clots in the 4 days post procedure. I wore Tena bladder leakage pads around the clock. Sometimes urinary urgency was so great, i urinated entirely in the pad before i could get to toilet. Luckily, after seeing on post procedure orders that Tylenol was recommended for any discomfort, I told doc on procedure day that I wanted Vicodin for pain.... he wrote Rx for 5/325 strength tablets...... but just for 10 lol. Luckily, I am Rxd Norco 10/325 for chronic pain, so I had good pain meds.

Today is Wednesday, Oct 4, 8 days post URO LIFT. I can do everything I did before the surgery, normal activity, normal diet from day 1. I'm watching caffeine intake, as it's irritating to urinary system... same for acidic juices.

I still burn somewhat when I void.....the head of my penis still is sore, mostly after urinating. I DID some reading and, please correct me if I'm wrong, I read where the URO LIFT device only holds 1 stent. It must be removed from the penis after a stent is placed, so it can be reloaded with another stent. Since I had SIX (6) stents placed, the device was inserted and removed 6 times to be reloaded with another stent. So, including the catheter insertion after the stents were placed, I had 7 insertions and removals of items placed into my penis. Ouch !!!!!!!.

I seem to be getting better each day. I hope I'm p*****g like a teenager in 3 more weeks. But I'm satisfied so far. If it works out as promised by my Urologist, it's all worth it. Yes, I WOULD do it all over again !!!

G

I'll gladly answer any questions.....one more hint... stock up on urinary leakage pad for MEN. I have several kinds on hand.... I liked Tena brand the best. I would advise getting the pads marked for MODERATE TO HEAVY FLOW. One more thing, I took Generic Senokot laxative, 3 to 4 tabs (without stool softener) every night at bedtime., as waste in colon will press on prostate, making elimination painful......you can take 60 ml, 4 tablespoonfuls instead of Senokot.

I'll keep you guys informed of any changes, or if you have questions.

I know everyone is different, but how long have you guys waited post URO LIFT to have sex ? Even it it's self masturbation ? Thanx guys...its been about 10 days so far and I'm getting impatient. Lol Thanx again, Tim , RPh

Age 57. Had Urolift done 48 hours ago at Frimley Park in UK. 4 inserts in what I understand is the newer 4D configuration (which I think means they position them in an X distribution around the clock). Not too large a prostate, no median lobe, but obstructive for years and Tamsulosin losing effect.  Woke up after op in a LOT of pain, given 2 x morphine and unable to clear much more than a trickle of blood. Surgeon surprised as rarely needs to catheterise, but after things started getting worse put a catheter in and just short of a litre came out of me. I think they might have filled me with saline a bit too enthusiastically and with the anaesthetic my bladder just wouldn't release.

Oddly, the other Urolift patient also had a catheter, so maybe 4D technique has a slightly different outcome. I think it is meant to clear the bladder neck better, so I can see that if these things are having an effect closer to the sphincter you're going to get a few more that decide to shut down in protest for a while.

Anyhow, after uncomfortable night and morning, urine was running clear so friendly weekend consultant on duty OK'd removal to see how I got on. What a relief. Felt better immediately it was removed. Filled bladder with 200ml before catheter came out and after 30 minutes of drinking passed a good amount and was like turning a tap full on. Now at home, up 4 times during night but feels good (fairly normal) between urinations after the discomfort has faded, so hopeful as inflammation and sensitivity improves, so will the results. Previously I could often go all night without a trip to the WC.

Main points of note:

Urine comes much more quickly and there is a definite urgency effect once you decide to go - so don't hang around. I suspect my bladder sphincter is a bit lazy after years of having the prostate do half its job of stopping urine heading south.

Flow was enormous the first day, not so good the second and is back to where it was before procedure. In fact it is split and a bit spluttery as though it is going through interruptions to the flow. I expect that's to do with the dilation effect of having a whole lot of equipment rammed through my pipes. As it's stinging and presumably inflammed, I expect it to settle down - but the main thing is there is no longer the sensation of needing to go again 5 minutes later or feeling un-emptied or as though urine is trapped in the urethra.

Stopped taking Tamsulosin but am on Doxazosin for high BP, which is a similar alpha blocker.

I had this as an alternative to HOLEP and so far am encouraged by early signs. Like TIM1250, I've lived with this misery for decades, it started in my late 30's after a bout of prostatitis and epididymal cysts. Things like airline trips were a nightmare.

Was almost certainly given antibiotics during procedure but nothing to take home. Drinking a peeing is advised.

After catheter removed discomfort nothing that a couple of ibuprofen can't handle.

I will try to update on progress this week. But if you are waiting for surgery, be re-assured.

Been looking at pelvic floor exercises to try to whip a few little used muscles back into shape while I am lazing around the house, anyone had any benefit from this?

J