Turp, again

I am going for physical therapy right now. The Dr. sees me soon and hopefully we will take it from there. I had an MRI done of the prostate area. Isn't that as good as an ultrasound? It showed scar tissue, but what do you do about scar tissue? It says the scar tissue could be the result of chronic prostatitis. Couldn't it be the result of the TURP I had 6 1/2 years ago. What is the answer and Why won't anyone help me? I am so tired of the discomfort I am having down there. If the shoe was on anyone elses foot, they would want to have an anwer.

  Steve 

I am sorry this is not an answer to some of what you said as I don't know about scar tissue.  But, I do understand that an MRI gives a more detailed image of the prostate - that is why they use MRI, I think, to follow up a high PSA before a needle biopsy; that is what they did for me.  And then if doing a transperineal needle biopsy, the previously-taken MRI image (fine) is super-posed on their machine over the image of the prostate from the ultrasonic wand up the rectum (coarse), to see where to put the needles.  A large fixed ultrasonic machine is better and is fine for checking your residual volume and so on, but I believe it doesn't give the ability to spot a tumour - although MRI seems poor at that, even if better than ultrasonic, as my MRI said 80% chance of tumour (but the radiographers' report seemed to backtrack even right after the line that said that, adding that the imageset was ambiguous and that inflammation might be all that it was), yet the needle biopsy just said the whole prostate was chronically inflamed.  Which he didn't know how to cure (no antibiotics were tried).  Hence I went for HOLEP. 

I don't understand. You had all this imaging done to see if you needed a Holep?        Steve

teve 

>>I don't understand. You had all this imaging done to see if you needed a Holep?

 - Steve, the MRI imaging was due to high PSA following LUTS-y type symptoms that came on sudden (checking PSA is good practice in such a case) - I also had years of declining flow before, which I had tolerated as I didn't even know there was a cure - too busy to worry about it most of the time.  The routine blood test showed high PSA, that is why I had the MRI.  MRI not needed before HOLEP.  The other things - renal ultrasound, cystoscopy - are said by uro's to be a good thing to try and figure what's what, diagnose anything (is your bladder mucked up or blocked or something ?) before you go to surgery (do you for instance have a bladder neck issue rather than just a prostatically-constrained urethra; do you need HOBNI rather than HOLEP) - and with the MRI result, help the surgeon plan the holep as he knows as much as poss before (the stricture risk partly relates to how long the procedure takes; the more is known before, the quicker it may be able to do it).  Well, that's what he told me.  It seemed no bad thing to me to cover these bases, before surgery; it seemed thorough.  Cystoscopy just showed prostate pushing up on bladder base, and a slightly spotty urethra which apparently loosely indicates past (or present) prostatitis (he did not say if indicative of bacterial, or the other mysterious sort of chronic prostatitis that is poorly-understood).  Looking at the bills (my insurer pays, but sends me letters telling how much it paid), I am quite glad I didn't have to pay for any of it.  I haven't yet seen the HOLEP bill.  Just got back Holep histology : clear !!

I hope so ,Grant. Thank You for being there !! I will write back soon.

  Steve

Hi Glen,

  I try to send you an anwer yesterday morning, but the system wouldn' let me.

   I don't know what the problem is Glen. I'm so frustrated trying to fiqure it out myself. Iv'e been reading alot about bladder stones and that may have originally caused the problem, I don't know. I get so frustrated because the discomfort is so debilitating. It seems like all I do now is spend the day exercising trying to make the discomfort go away. Strecthing. This is not the way I thought retirement was going to be. I had such plans when I was in my 50's. Do you think going back up to New York and talking to the Dr that did the TURP would help at all? He is getting ready to retire now and when I tried to call him around half year ago, he wouldn't return my call. The thinking being is " if he's the one who did the Turp, then he's the only one who would no what the problem is. No other Dr. would know what to do because their not the ones who did the Turp on me. Therefore they wouldn't understatnd what the problem is". Is that good thinking, Grant? Can another urologist help me where the urologist up in NY who did the Turp can't? 

  I would like your feedback

     Steve

Hi Steve:

I would recommend your GP who knows you as the first port of call. A GP may be able to prescribe medication, for instance, Oxybutynin which reduces bladder spasms. A competent doctor should also be able to recommend a Urologist that he trusts in the area that you live.

A specialist should return your call, if you phone them. The problem is if you live a long way away now, his recommendation might well be to see him again. This might be impractical and costly.

I'd definitely start with your GP, try to experiment to get something prescribed that will relieve the discomfort and maybe organise a different Urologist. If it gets bad enough, you can always go to the ER. It seems to be you've been a bit too brave, bravery and suffering aren't always rewarded. Snivelling cowards like me who go crying to their doctors, probably get more attention!

Hi Grant,

  I'm getting a lot of spasms or contractions down there and I just don't know what to do 6 1/2 years into this turp. Did you have any problems after your procedure was done? I feel uncomfortable down there. I don't feel the same. By the way, your not a coward. Do you feel any different post turp than you did before. I'm trying the pelvic floor procedure right now and it's helping a little bit but after 6 yrs. I'm impatient. If indeed this is scar tissue.

  Your feedback is helping me a lot. It's nice to hear from someone who has had similar experiences such as I In regards that you had turp done also. I assume it's a classic turp with the loop you had done. I was given no other alternative and it happened back in 2009.

  Thanks for staying with me Grant,

    Steve  

Hi Grant,

  Just an observation. I read another advertisement about a prostate formula and I was just wondering why you and I had the turp done. If there are so many men being helped by these new medicines why were we not given the chance to try one. It seems as if our Drs. pushed us into this Turp so to speak. If there are so many men out there being heped by these formulas why couldn't we be one of them. I just read another advertisement that came through my email and I look at all the men who are older than you and I and I wonder why could they be helped and not us. Is it that their ship came in and ours didn't. I guess my pain doesn't make things much better. I'm sorry to rant like this, Grant. When I see older men who are happy and have there prostate problems solved with a pill AND I think of what you and I have gone through it makes me mad. I'm sorry, but I wish we were given more options before we had the surgery done. I may have been better off and not going through the pain I am going through. I just so much want to get on with my life. I hope you will not be angry by what I have just said. I need to get this off of my chest. I wonder why I wasn't given this option.

    Steve

Thanks, Grant !

The only other thing, Grant is that the pain seems to be defined to one area. I noticed it right after I had the surgery, but said nothing because the Dr. had such a bad bedside manner.  Now I'm beginning to wonder. A pity isn't it, to be afraid of a dr. but that's how bad this mans personality was. I do hope that my new Dr. will have the compassion and care to- help me! Nobody should be in pain.

  Steve