TURP

David my own strategy was pretty simple. I won't bore you with details but I had a very large prostate...125 cc and all the usual BPH symptoms. I visited three urologists ....one wanted to do TURP, another Holep and the third wanted to do open surgery on me. I did some extensive research, consulted with many on this forum and eventually decided to have a PAE a year ago. Great success ! BPH Symptoms completely gone and I don't even think about peeing anymore. 

At the time I considered PAE to be the best option because of least chance of unwanted side effects. I reasoned that it made sense to have the best proceedure first. If that didn't work my next step would be Holep. I don't think I could have brought myself to have a TURP and open surgery was unthinkable. 

My issue is that the first urologist missed my distended bladder, and with only a mildly occluded prostate, said TURP was my only option.  She never mentioned CIC.Thats when I went for a second opinion. This time the urologist did both a cytoscope and TRUS, and viewed the CAT scan I had brought in (the first one never looked at it). He opined that surgery might help, but might not, so I opted for six months of Tamsulosin, Finisteride and CIC. Six months later I did better on the flow test(thats another story) and he suggested Rezum, which they had only been using for two months at the Cleveland Clinic. It has worked so far! I'm trying to decide whether to continue with the two meds, as they have side effects-nothing serious but why take them unnecesarily.

So as you can see obtaining a second opinion made a big difference. It is hard to believe a competent urologist would fail to detect a distended bladder but she did.

That's the problem. My urologist only mentioned Flomax, which didn't work. My flow was terrible.

Why did you reply then.

Great comeback, all kidding aside.  It would be great if someone could do a detailed survey on men who have had the multitude of procedures on their thoughts over the years.  Obviously, % that had complications and what, the success rate, have they had to have another procedure, the time wearing a cath afterwards and so forth.  This is a great site and you can get a lot of info but only from a very limited number of men.  I have had issues for years and tried to avoid any procedure by using drugs which also have complications.  The advantage there are now more procedures that are not as drastic as a turp or some of the other treatments that are also drastic.  Has anyone any knowledge of a large survey of any type that has this info?

That's the problem. I was not given the alternative for drugs. If I was then I certainly would have taken that route. Was given Flomax but that certainly didn't work for me !!

I have taken Flomax and Avodart for a long time. They both have side effects, but have allowed me to avoid surgery for many years. Avodart takes time.  I can pee and do not have to wake up often.  I am now exploring some less evasive procedures, the most promising seems to me to be PAE.  A urologist will not even tell you about it, since it is done by an Interventional radiologist.

I wish such a data base was available. Unfortunately most group practice urologists only use one or two procedures.The advantage of the larger medical centers is their larger patient volume, plus most of them offer TURP, along with more than one other option (i.e. Green Light, Holep)

I will reply later, Roy. I had 3.2 cc/sec urine flow, bladder stones, my bladder was 1/2 full of residual urine and it was infected. This was done years ago and I am still having problems

Am still here, Roy !

Hi Roy, i guess you like me must be in the UK?? my TURP was the only option at the time March2015....i am 68 and very fit!! the op was easy!! the recovery was so-say textbook, and after6/7 weeks i was back on my bike and other exercise. What interested me was your UTI comment..my BPH problem( neck of the bladder blockage) was highlighted by a Uti, ( never had one before and hope never  again!!!!!!)  even after the anti`s had eventuall clea\red the Uti (6 Weeks of varing degree`s of pain whilst urinating) and then the constant trips to the bathroom at night, and days!! moire discomfort. eventually my Uro said to clear the blockage we must do a TURP, that was the  only way in, and so they did, and it would appear the problem is "fixed" my concern is the UTI, how and why.....(dehydration) my flow now is very good, so i`m guessing that retention is not such a prblem??so uti`s less likely!! i live most of the year out here in Portugal and cycle in anything from 12-40 degree`s drink plenty, but would welcome any advice or thought`s??  otherwise akk is ok, and i guess like you said, most successes don`t do forums like this!! regards Syd...btw my URO was no help at all with this discussion at all!!!!!hmnn

And you would not have known about the cancer if you'd had PAE. Not for years anyway. 

 

Thanks for an optimist accent. Don't worry about your cancer, most of them are not aggressive. I have had prostate cancer for 14 years now, started with Gleason 7, now Gleason 8 without any anticancer treatment,as I refused all of them. I accepted a few hormonal shots 3 years ago. You are still young, so be careful with your cancer decisions.