Turp experience and questions

Hi Clive,

I think your case is very typical of men with bph, though you are a bit younger than many. I think to get a good baseline of where you are you should request the results of a sonogram that measures the size of your bladder, measures the PVR (post void residual - how much urine you retain after voiding) and also determines if your median lobe is protruding into your bladder.

I've had two greenlight lasers and a classic turp, and the turp was a better procedure for me because I had a very large prostate ( it reached 300g prior to my turp.) Many people on line have had good things to say about the holep laser procedure, so if that is available it may be a good option. In my experience the Greenlight laser was a more painful recovery than the turp and the results were not as good.

Prior to my first Greenlight laser my PVR was about 400ml. I think anything over 250 ml would require a procedure so as not to damage your kidneys.

I had the retro and for me it was a non-issue. I don't know how you measure or remember the force of your orgasms but I'll go with a line I heard in a Woody Allen movie .."Every orgasm I ever had has been spot on".

One thing to be aware of is your nocturia may not be cured by any procedure. I wouldn't use the overactive bladder medication as it gave me dry mouth. Itdoesn't sound like it's working for you. The Tamsulosin only worked for a few months for me and stopped working. I still get up 3 or 4 times a night. I use a bedside urinal, sit on the edge of the bed in the dark to void and snap the lid shut, and get back to sleep in about a minute.

Clive, I meant to say a sonogram that measures the size of your prostate rather than your bladder. A picture of the bladder and your report will indicate if your median lobe is protruding into the lower bladder.

My understanding is HOLEP the odds are very low for impotency. Some patients actuall have improved sexual function. I was told RE happens about 85% of the time. I'm going in with full knowlege of this. 

I have not had surgery yet scheduled tenatively for January 2017

HI Bob, 

thank you for your detailed response, I really appreciate it.

I did have a songram on my bladder after my initial flow test to check my PVR, and there was only 20ml left in it, so I don't think the urologist is too concerned in this regard... they haven't checked the size of my prostate though as far as I am aware. I did have cystoscopy done, and a specialist checked my bladder and could see no anomolies.

I do experience quite a bit of discmfort in my pelvic region though, even when my bladder is empty.

I am unsure as to whether a holep  procedure is available to me, as this is on the UK National Health Service, but I will do some investigation into this. If not, I would have to see a specialist in private practice.

The urologist has told me to stop taking the medication if it is not being beneficial, basically saying that the only real option open to me now is surgery but it is up to me to decide if I feel my discomfort and symptons warrant me having it. he did explain that the nocturia symptoms are the least succesfully treated by this procsudre but did say there should be some improvement. I currently wake up about 7 to 8 times to urinate, so if that could be reduced to just 3 or 4 times, it would be hugely beneficial.

I do also cutrrently use a bedside urinal but thank you for the tip... it does make a huge difference not having to walk all the way to the bathroom... my problem is though, that at least twice a week, when I wake up to go at about 3 in the morning, I just cannot get back to sleep until around 6 am and then of course I need to get up at 7 to go to work!

I am very tempted to go ahead with this procedure . My urologist has stated that most men are happy they have had it but did state the risks involved. I will do as much research first before Imake any firm decision.

Thank you again for your input, it is really much appreciated!

Thank you for your response, I will check to see if a HOLEP procedure is available on the NHS

Good luck

I had a membrane at the start of the prostate blocking a large portion of the prostatic urethra about 6 months after a Greenlight laser turp for bph. It was removed with the cystoscope with just lidocaine for an anesthetic. My doctor said they might return. I had read an article on the internet about how the Chinese use a sterilized metal chopstick to keep the channel open. I asked my uro about it. He said I could self cath every two to 4 weeks to keep the channel open or have another laser procedure. I opted for self cathing every 2 to 4 weeks for a year. At the end of the year I had a hematuria and needed the second Greenlight Laser anyway to cauterize the bleeding spots, but the stricture never returned. In the Chinese study, about 75% of the people who did the cath procedure with the round sterilized chop stick for a year did not get another stricture. Those who continued after a year never got another stricture.

That chop stick procedure sounds like it hurts

No more than self-cathing. I used a 16Fr self lubricating one time speed cath packed in sterile water evry couple of weeks for a few times, then once a month. They cost a little more than a dollar each. I think in China they went with the lowest cost option. I also checked my post void residual at the same time by collecting the urine in a plastic urinal with ml. markings.  

I had same problem. They put it back in for a few,days giving my body longer time to heal. Make sure you clean catheter as you want to prevent infection. You will be fine.

I had my oparation in Sydney Australia on the 3th March. they took the catheter out of me after 2 days and they sent me home. On the 8th day I couln't pee at all. I rushed to the hospital at 2 o'clock in the morning with a full bladder, i thought i will blow up and die. they put the catheter back on me and they arrange appoitment to take it out after 3 weeks. After 6 days with catheter i couldn't stand the stupid thing inside me. I call my doctor, told him my problem and he arranged to take it out the next day. I'm 80% better now. People should not keep the catheter more than a week. it could give you infection. 

Steve I also live in Australia, Mildura Vic. I had my op on the 9th March and also had to go home with the catheter. Had it taken out on the 29th as I was getting very swollen where the catheter went in. I still leak alot. Have you had that problem. I had just had the catheter out a week and I was in hospital again with pneumonia. It has kind of set me back. I mainly use a urinal bottle so that I can tell how much urine I am passing. The urologist told me I would leak for a while but it would get better. How have you been after your op. Sometimes I feel I was better before hardly passing urine but I was leaking then too.

Hi John. Don't worry because you will get better after a few days. The worst thing doctors do to their patients is to stick the catheter in them and keep it for 3 bloody weeks. People get infractions because of that or the catheter stretches the urethra that's why you get to leak a lot.

7 days after the operation I hat a blockage I could not pee at all so at the emergency (2 oclock in the morning) they put the catheter in me again but I refused to have it in more than a week so after 5 or 6 days I forced them to take it out. I think catheter is the reason you leak a lot. You have been strecthed inside, but soon you will go back to normal if you start doing the exercise for your bladder. I don't have leaks but I still have pain.

I wish you early recovery mate.

Thankyou so much for your reply Steve, I have started doing pelvic exercises. Not sure if I am doing them right. All along I have had no pain or bleeding. When I had the op they took the catheter out after 3 days and then had one pee and none after that. They then put in another one and that hurt like hell. they took that one out and put another one in and then sent me home. I am sure the urologist didn't want the catheter put back in. I live in country Vic and he comes up from Geelong once a month. When I went back for my monthly visit he said they must have thought it was needed to have been put back in. I just think it put my recovery off 3 weeks and I agree that the urethra would be pretty stretched after all that time. I never thought about that before you mentioned. it. I am 75 and really had enough. Used to play golf but because I leak alot can't do that yet.

I had two surgeries..about a year apart.  First Green Light PVP Laser prostate surgery and a year later I had the popular TURP.  It was tough going each time.  But now I am doing great.  My advice....hang in there, stay close to bathroom, listen to your doctor and if he/she is difficult to get a hold of....keep calling.  You will be fine in time.

Thanks Bruno. How old are you. I just thought I would be better sooner. The urologist made it sound a really simple thing and I didn't expect all the leaking. Luckily I can pee I suppose,  I usually use a urine bottle so that I can keep a track of how much urine I pass.

Thanks again Bruno

I am older than dirt....61