The Urolift procedure; patient views and questions

Justin,  Sorry the urolift did not work out for you and you are having so much trouble.  There seems to me lots of variables that go towards effectiveness of the procedure.  Best of luck.  Bob

Justin if you have open, I suggest you get opinion of another good urologist, I don’t know how old you are, I hate to hear that someone has to have catheter everyday for rest of life! May be another corrective procedure may take care of it.

i have procedure done in September and I love it. No pills, good life! Hope this will get you out of misery.

Justin:

I second Dan's post.  You need another urologist, now.  My procedure has been life-changing for the better. 

Good luck,

George

Justin.  I am so sorry that you had a bad out come but That was your doctor fault.  My urologist has done many over the last 3 years and so did the Jersey Group Doctor.  Your doctor did it to you.  I wonder how many others he mess up.  There are many men on here that had from 2 to 8 clips and nothing like what happen to you happen to us.  I am going on 3 years and all is great.  Let me ask you something did the doctor want you to have another procedure.  Like bob said go to another doctor it can be fix  Good luck  Ken

Chris. Sorry you had a bad experience. I will be 2 years with Urolift in February. I can't say enough how beneficial the procedure was for me. My urologist was very experienced with doing the procedure and a tech from urolift was in the room to oversee the procedure. If you read the forum the results vary based on each man's situation but the experience of the urologist is probably the most important factor. You might want to see another urologist who has more experience with urolift. The urolift is a good procedure and has improved my quality of life. Good luck.

Chris sorry that your having a problem.  Did you get up a lot before you have the urolift.  It could be just habit.  That does happen.  They should have some kind of records at the hospital.  How many clips did they put in.  If your still having a problem you may need more.  When i had mine done in 2015 I had 4 put in all is fine.  I know there are some men that have to have up to 8.  If this doctor will not help you go see another that will.  Good luck  Ken

Hello Ken,....I was put on finesteride and tamsulosin quite a few years ago but quit finesteride as it appeared to give me RE, or at least that's what my GP said caused it.....I have been getting up many,many times for a pee during the night for years, and when this urologist said a cure was just around the corner when NICE approved it on the NHS and it was called the Urolift....My GP's practice had never heard of it and had to Google it!..The urologist gave me the name of another urologist out of county,whom I consulted but I couldn't afford the £5.5 K he wanted for the job!....Just think how I would feel now if I had spent that money for no improvement?

I am now going for a 2nd opinion on my probs, but out of this area and have asked my GP's practise to give me all copies of my notes etc....

When I complained to the urologist that did my Urolift, he then wanted to do a bladder neck incision which sounded pretty grim result wise!....I saw my GP yesterday and have been complaining of ghastly lower back pain in the morning, and wondered if because my bladder needed relief several times during the night urine was backing up into the kidney's?.....Do you think this is a possibility as I'm no doctor......Thank you Ken for taking an interest in my woe's.

You have to re train yourself because you did get up a lot at night.  Stop drinking at night or limit your in take.  If that Urolift was done right it should have opened you up or like I said you need more clips.  Do not let him touch your bladder neck.  That is 100% retro. When did you stops the meds.  If you were on it for a while it will take time for your body to get back to normal.  I was just in the hospital.  My bladder just stopped working.  All is good now.  My doctor said it was just a fulk.  They gave me Flomax which I don't like.  It causes retro.  I only took it for 9 days .  It took 3 weeks to get out of my system. Like I said do not let them touch your bladder neck.  NeoTract The company that makes the Urolift does not regulate the doctor or the procedure.  They are letting the doctor add to the urolift which changes the procedure.  Longer healing time and it causes retro.  There making it just like all the others.  I still say you need more clips.  If you can see another doctor.  I know in the UK  you are different  from us in the US.  My doctor will never change theUrolift.  He said it has work for many of the men that he has done.  In 3 years he has done over 200.  I was the 10th man he did.  going on 3 years for me.  Watch you salt intake to  Ken

Hi Chris,

Sorry you're having problems. Sounds like you need a complete workup before making any decisions. Hopefully you have had all or some of these tests. A bladder/kidney ultrasound study is a good start and will tell you if your kidneys are being compromised. A simple office bladder scan will tell you what your post void residual is. A cystoscopy will look for any issues that might be causing your symptons. And urodynamic testing will measure bladder pressures/function so you will have a better idea of whether the problem is your obstruction or the bladder. As to a bladdder neck incision, my understanding is that will give you permanent retrograde ejaculation.

Jim

Thanks Jim.  I know you would be in on this.  Yes he needs to see a doctors and have more test.  I just hope that the doctor did it right and not did it wrong just so he can get him in for another procedure.  They need to stop adding to the UROLIFT.  They are only doing them in the UK like this.  My doctor and his partner told me that they would never add to the UROLIFT because it changes the procedure.  Take care  Ken

Thank you jimjames for your kind input on my Urolift problems.....I'm no medic but I sort of understand what you're saying and it will go on my list of questions when I have my meeting with a new urologist, out of my area in the new year.........Cheers, Chris.

Chris that is good to know.  Ask question and don't be pushed into anything you don't want.  Them pictures are somewhere or did they get rid of them for a reason?  Good luck with the new doctor and in the New Year  Ken

>>As to a bladdder neck incision, my understanding is that will give you permanent retrograde ejaculation -

ha, I was on the trolley just before going into theatre for my HOLEP, and my Uro' said, I might just do a Holmium bladdder neck incision? (Hobni) instead.  I was aghast because we hadn't ever mentioned that at the previous appointments, it was 9pm (he was running 3.5 hours late), and I feared he might be saying it only because it was late and he wanted to do something quicker than Holep.  I had no idea what it even was and no way to research it.  I said no, I want Holep; he said you have to trust me.  Anyway first thing I asked when I next saw him after I came round was "did you do Holep", and he said yes (I know he did as he shared the film of it with me, and the histo'y results).  When I finally had access at home to a computer, days later, I googled it - I could only find one comparative study of holmium bladdder neck incision? (Hobni) vs Holep, and it showed a somewhat higher success rate for Holep. The leaflet,  

"incision of the bladder neck : Information about your procedure from The British Association of Urological Surgeons (BAUS)" seems more positive in its stats than other sources; ony 40% get retro (in its green key points box), or as few as one in ten (same leaflet, in the "risks" table); that leaflets says it fails to COMPLETELY relieve ALL your symptoms only (risks table) in between 1 in 50 and 1 in 100 cases, which is a remarkable assertion of success; but then if you google "hobni vs holep?" you see something different : 20 men (prostate <40g) had HOLEP, the other  20 (also prostate <40g) had HOBNI, all for LUTS, randomly assigned.  Two patients out of 20 (10%) in the HoBNI group required recatheterization compared with none in the HoLEP group.  "Five of the 20 HOBNI men (25% !!!) remained obstructed urodynamically at 6 months" (this was true of none of the 20 Holep men, all of whom the Holep worked for). Of these unfortunate 5 men in the HoBNI group, 4 of the 5 men had a prostate that was greater than 30 gm.  So Hobni is concluded in that paper to work better for prostates of below 30 cc (mine was assessed at 28cc pre-Holep, maybe that is why he decided at the very last minute to offer me Hobni.... if he'd discussed it with me rather earlier, I might have said OK...).  Also of the unfortunate 5 men for whom Hobni didn't work, 4 of them opted for HoLEP to cure the persistent lower urinary tract symptoms that Hobni hadn't worked for.  That study doesn't give incidence of retro (which I think for Holep is common, but evidently not universal as some men don't get it).  It is definite tha HOBNI is quicker than HOLEP in all cases.  I found another study "Holmium Laser vs Monopolar Electrocautery Bladder Neck Incision for Prostates Less Than 30 Grams: A Prospective Randomized Trial" - it says the incidence of retrograde ejaculation was significantly higher in HoBNI than it is for electrocautery Bladder Neck Incision (22.9% vs 6.1% ).  In all cases prostate size was < 30 cc.  Conclusion is, "The risk of postoperative hematuria is less with HoBNI than with for Electrocautery Bladder Neck Incision because of HOBNI's better hemostatic properties [meaning, teh laser seals the cut], but its use must be counterbalanced with significant increase in incidence of retrograde ejaculation".

?On the whole I think I'm just glad I went for Holep; had I had Hobni, knowing what I know now, well there's a chance of say 75% it would have worked, and a 75% or so chance of not having retro, but the 25% chance of having to come back and be messed about with more later on, had hobni not worked, means I would probably have gone with Holep and its high chance of retro.  Having it mentioned for the first time just before going into theatre meant I wasn't sighted on it at all, and was unsettling as I wasn't quite sure if I'd wake up and find he'd done it !!!!   I think if I hadn't said no firmly he probably would have - it takes 30 minutes (which probably includes setting up time); the film indicates my holep took 35 mins to actually do, but that is ignoring any setting up time, and I think the quoted time of 90 minutes average for Holep includes setting up time? and sedation before you get to the uro.  i.e. 90 minutes from patient perspective not from uro perspective.  For a larger prostate on average than mine. 

Thanks for that info Paul, I'm afraid it was all as we say 'double dutch' to me, but I certainly am making notes to be able to question my next urologist!.....Again many thanks....Chris.

Hi Paul,

Glad things worked out. The percentages on retro after bladder neck incision seem to vary, but I stand corrected that it's not a given.

Jim

Yes Ken, I too found it odd that my photo's had mysteriously gone missing !....I have several times requested them via him and his secretary....During my last consultation with the surgeon he produced my record notes and even opened a blank page where he said they ought to be!.....muttered with a smile something about them maybe hanging in someones gallery!.....and now his sec won't even reply to my texts.

Thanks for your feedback Ken............All the best Chris.

That is why I don't sign anything that I don't read.  I do not give my doctor fell control.  You do what we talked about and do not add or subtract anything and no changing your mind the day of the surgery.  .  Once you sign that paper for the surgery they can do what they want.  A man on here did not want a Turp and he only wanted a Tuna.  The doctor told him I know best and I am the doctor.  After a few month's the doctor agreed.  Well when he woke up the doctor told him that he was bleeding to much and had to do the Turp.  The guy was upset.  Well when the doctor was leaving the room the man heard him say to the nurse.  I told you that I would do the Turp on him.   Take care  Ken 

Yes that sounds very fishy.  Good luck with the other doctor  Ken