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Trying to decide on HOLEP, not 100% sure I need an operation

Posted , 15 users are following.

John-T
John-T

Hello everyone, I have been diagnosed with BPH about 3 months ago and still wearing a catherter since that time waiting for an HOLEP operation. I have tried CIC and failed, actually passed out in the nurse washroom fell on the concrete floor bangging my head and noze pretty bad. 

I'm not even sure I need an operation, it all started 3 months ago when I felt ill, went to the ER and had my creatine level at 230, at first they didn't know why, then they did a bladder scan and had about 800ml of urine after void, I never had problem urinating, the flow was normal but I was going often and couldn't hold it in longer. After also an echo of the prostate, they told me it was very large and needed an operation. They prescribed me Flowmax (tamsulosin) but it did not do much. 

I don't understand why they did not prescribe me the combo med, Flowmax is considered a a1 Alpha-blocker (helps relax the muscle around the urethra) and another popular drug a 5 alpha reductase inhibitor like Avadart (a dutasteride) that shrinks the prostate, there is also another drug called bethanechol chloride for detrusor muscle contraction for urinary retention, not sure if some of you men are aware of these drugs or tried it as a combo. It seems to me that urologist just wants to operate, they signed me up and make me wait but in the mean time we did not try these things. 

In any case, this coming Monday, I'm going again for another prostate echo and tuesday I have another appointment with a second urologist for green light surgery.

Another thing I wanted to ask your men of BPH suffering, have you tried CTM ( chinese traditional medicine for BPH) according to them, they say that Urologist in our countries dont' understand the prostate and just want to destroy it, apparently they say that the prostate is calcinated and need to remove the heat and restore normal blood flow to shrink the prostate naturally, even ncbi gov sites did some research, herbs such as: Rou Gui (Cortex Cinnamomi) Huang Qi (Radix Astragali) and Chuan Shan Jia (Manis pentadactyla L.) (41.9%), Shu Di Huang (Radix Rehmanniae Perparata) (38.7%), Shan Zhu Yu (Fructus Corni) and Fu Ling (Poria) (32.3%), E Shu (Rhizoma Curcumae), Huang Bo (Cortex Phellodendri), Ze Xie (Rhizoma Alismatis) and Wang Bu Liu Xing (Semen Vaccariae) . Wondering if anyone ever tried these

I appreciate feedback from you all including my friends Ken and Jim

John 

1 like, 63 replies

63 Replies

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  • rogcal
    rogcal John-T

    Posted

    Hello John.  By all means try everything under the sun to avoid surgery in an attempt to relieve yourself of the symptoms of BPH but the longer those symptoms persist the greater the risk of developing long term issues.

    I put up with my BPH for almost 10 years and refused surgery when offered and as a consequence almost wrecked my bladder. I tried all the meds and supplements available to resolve things but all to no avail.

    Following a HoLEP procedure last November my bladder has finally returned to normal and I no longer have to put up with having bladder stones removed every couple of years and I've kissed goodbye to the regular doses of anti-biotics to rid myself of the recurring UTIs that were occuring due to constant urine contention.

    Good luck.

     

    • John-T
      John-T rogcal

      Posted

      Thanks for your great feedback Rog, not sure if it's Roger 

      I know I'm in good hands with the HOLEP urologist since he's a pro at it and is also teaching young doctors the HOLEP method, I just have some fears about the bleeding, the retro and who knows about sexual functions after the operation, erection, etc. 

      Got another echo for the prostate on Monday, I'll have more idea on the size of my prostate. 

      I'll keep you posted

      thanks again

      John

    • John-T
      John-T rogcal

      Posted

      Hi Rog  I live in Canada in Montreal
    • rogcal
      rogcal John-T

      Posted

      Hi John.  You mentioned that your man trained up other surgeons in the HoLEP procedure and thought that it may be one and the same person however not the case.  My uro surgeon trained in NZ with the developers of the HoLEP procedure and is now at Addenbrookes Hosp near Cambridge, UK and has been training others from around the globe in its use for over a decade.  
    • John-T
      John-T rogcal

      Posted

      Hi Rog

      Ok sounds like he knows what he`s doing, my Urologist name is Dr. Elhilali, he`s 80 years old and the only one doing HOLEP in the whole province of Quebec (scarry when you thinking about the operation, I mean 80 years old is not young), I think there are only a couple of experts in Canada. So for me it`s either him or a green light expert dr. Zorn well known also. 

    • rogcal
      rogcal John-T

      Posted

      Hi John. If he can keep awake for an hour you will be fine.  Only kidding, I'm sure all will be OK if and when you have the procedure.  One point I would make is if you are happy to have a spinal block anaesthetic rather than a GA, go for it.  I've had 4 procedures in total on the prostate and bladder, all with a spinal block and recovery has been swift and trouble free.  One point to remember is don't let the nurse remove the temporary catheter that they insert for a few hours, until all sensation is back in your legs and lower trunk.  If they take it out too early you will not feel yourself peeing (your bladder will still be affected by the anaesthesia) and the first you will know about it is when the pee begins to cool around your backside where it will have collected on the sheets. A learning curve for the nurse in question and she had to change the sheets.  Of course if you have a GA you will remain continent but dozy for a couple of hours. I prefer to keep awake, talk to the operating crew and have a few laughs on the way.
    • John-T
      John-T rogcal

      Posted

      Hi Rog, yes let`s hope he doesn't decide to go for a nap during the operation, all kidding aside for the anaesthetic it all depends how I feel on that day, I guess spinal block is like epidural for a women when she gives birth, ouch we'll see GA could be a better choice for me if I'm too anxious. 

      In any case I still have time to decide, let's just see how it will go Monday and Tuesday. 

    • kenneth1955
      kenneth1955 John-T

      Posted

      JOHN i would not have anyone 80 years old doing any surgery on me His hand may not be steade. I don't want anyone shaking going inside me ken
    • John-T
      John-T rogcal

      Posted

      Hi Rog

      Thanks for getting back, yes I understand what you mean. The issue I have is what if I do the HOLEP and still can`t urinate, because the way it all started about 3 months ago is I felt ill but I was urinating ok, normal stream, mind you I was getting up a few times at night to urinate and could not really hold it in when I had to go I had to go, but turned out that my creatinine level was 230 from the urine retention so I most likely had urine retention for some years and didn`t know about it. So is it the prostate that is causing the urine retention or the bladder is stretched, that is my dilemma. So by wearing a cath for the past 3 months I gave my bladder a rest but I also installed a valve on the catheter so during the day I don`t have the urine bag, just at night, so day time my bladder get to do some work. So I suppose by doing the prostate echo on Monday I `ll have more ideas on the size of the prostate.

      I`ll keep you posted

      Thanks so much

      John

    • John-T
      John-T kenneth1955

      Posted

      Yes Ken I have the same feeling but he's the only one around in MOntreal or even in other Canadian province doing it, my other option is Green Light with a younger urologist but I heard not so good stories with green light, 

      Thanks

      John

    • tom86211
      tom86211 John-T

      Posted

      John,

      Before the HOLEP procedure you will go through testing to see what is going on. The doctors aren't going to do the procedure if it isn't going to help. HOLEP is like scooping out a hard boiled egg then chopping up the egg into little pieces. It can make a substantial reduction in your prostate volume and is particularly suited to large prostates and median lobe issues. So, the first step is to know exactly what is going on, then make a treatment decision. 

    • John-T
      John-T tom86211

      Posted

      Hi Tom

      Thanks for the message, yes I agree with you but what had happened orgininally is I was seen by a first urologist and after doing, bladder scan, blood tests, urnine test, echo of the prostate, systoscopy, the urologist told me that my prostate was large and needed an operation and that my bladder where stretched and swollen from retention, so she wanted to go the TURP road because that's all she knows but she wasn't sure that by doing the TURP I could urinate because of the streched bladder, I was never given medication therapy other than flowmax (tamsulosin). So I went for a second opinion for green light, he looked at previous tests done from that women urologist and gave me a systoscopy date for June 7th. The third urologist the one for HOLEP that I saw last april for the first time, did a rectal examination look at the file from the first urologist and signed me up for the HOLEP operation, 2 months later this coming Monday the 6th of June he gave me an appointment for an echo of the prostate, so so far the HOLEP doctor did a rectal and now the echo, no meds where ever prescribed or proposed. I'll know more from the echo on Monday.

      I'll keep you posted

      Thanks

      John

  • tom_bob
    tom_bob John-T

    Posted

    John-T

    Sorry about your problems,man.  Getting old ain't for wimps, huh?  A couple of VA doctors malpracticed on me 8 yrs ago and among numerous other things they fixed me so that i can't urinate but have to self cath.  And, i tell you man, the first time i tried to insert one of those foreign  objects into my body i got master caution lights and whistles and abort buzzers and be sure i did abort.  i didn't faint but i came close.  So, after 2 or 3 hours i tried again and may have aborted the second attempt also. (do know how i changed font style here)  but, after i got past the FOD, foreign object damage, i could empty my bladder completly with hardly any discomfort.  no more need to get up at night 2 or 3 times.  i don't take any drugs for the prostate-that's what ruinedme 8 years ago.  aand i don't want any operations at this point.  At 66 life could be better but it could sure be whole lots worse.  i guess what i';m saying, John, is you might give that self cathing idea another chance in a safer environment where your not likely to hurt yourself.  You might find that to be your healthier option.  i'm sure you'll sort it all out.

    tom bob

     

    • John-T
      John-T tom_bob

      Posted

      Hi Tom

      Great to hear your feedback on my post, yes you're right about CIC, I just need to get my brain to accept that it's ok, it seems that I have a mental block about it and freak when I see the length of these things going in. I'm not confortable with the operation because I'm not sure it will cure my problem. 

      In any case I'll keep you posted, I'm booked for an echo of the prostate on Monday, I'll know more if my prostate is still huge or shrunk a little with the rest, natural herbs and diet. 

      I'll hope for the best

      thanks again

      John

       

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