TURP in Manila

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I hope this helps anyone unfortunate enough to suffer an unexpected Acute Urinary Retention AUR while in the Philippines......

On June 19, while at the Sofitel Manila, I was suddenly unable to urinate and had severe pain in my lower abdomen and back. I had never had such a problem and so went to the hotel clinic. "It's a UTI, drink lots of water, we'll test a urine sample." was the hotel doctor's advice. 2 hours later I was told the sample is clear, it's not a UTI, drink lots of water.

6 hours later I was in the ER at Manila Doctor's Hospital in very severe pain. After 2 hours of hot and cold compresses(?) to my lower abdomen, I had the first catheter of my life...........not the best memory I have, especially as it was in an open room with other patients, male and female, spectating!

In less than 20 seconds 1.3 liters of urine flowed through the catheter, and over my undershorts and pants because they didn't allow me to remove them first! The doctor removed the catheter and said I would be discharged, but another doctor suggested a CT scan because he was concerned about kidney stones. 2 hours later, I was again in agony and not able to urinate. The CT scan was done, I was told I had a very enlarged 68g prostate gland that caused the AUR.

The doctor inserted a Foley catheter, discharged me from ER (total cost PHP17,400) and sent me to a urologist in the same hospital. The urologist prescribed me Fozal (Alfuzosin Hydrochloride) for the AUR and antibiotics to stop infection from the catheter. He told me to return after 7 days for catheter removal, after which he assured me I would be fine provided I took Fozal for the rest of my life. His fee was PHP1,500, the Fozal and antibiotics were around PHP4,400.

At that point my life felt pretty bad. Yes, that's an over-exaggeration compared to the millions who suffer far worse than an AUR, but for me, catheterization and a urine bag hanging on my leg, felt like a disaster. Surprisingly, what happened next was the catheter became my best friend, because at least I didn't need to worry about the pain of another AUR as long as it was inserted. Insertion I hated, but once it was in I could live with it. In fact I decided at the end of the 7 days to ask the doctor to delay catheter removal for a further 7 days so I could be certain the Fozal had taken effect. The doctor agreed and then came the next shock: "Please bend over so I can do a Digital Rectal Examination DRE"............a what?? Ten seconds later the doctor was acting like a pervert, telling me he was using lubricant "So you'll like it" and that he was going to "Pin your a$$". Maybe it was just his bedside manner intended to put me at ease, or maybe not, I'll never know. The only good news was he said my enlarged prostate was benign, not cancerous.

7 days later I returned to the doctor and he removed the catheter. For 24 hours all was well, I was urinating and assumed I was OK. Wrong: 1am the following night, I was back in Manila Doctor's Hospital's ER where, despite knowing my case details, they made me wait in agony, with useless hot and cold compresses, for 3 hours before they re-catheterized me.

I needed a second opinion at a decent hospital, so I visited Dr. Dennis P. Serrano, Chief Urologist at St. Luke's Medical Center Global City Manila. What a difference! Dennis did a DRE but I hardly realized. His manner was very professional and he seemed to know exactly what he was doing. I had already decided I wanted a TURP because: 1) my first trial removal experience had been a disaster and I did not trust Fozal to correct my urinary problem, 2) the cost of Fozal at $150/month for the rest of my life (I'm 58) seemed a waste of money, 3) I didn't like the side-effects of Fozal, and 4) I was concerned what would happen if I had another unexpected AUR while in an airplane.

So on July 25, Dr. Serrano did my TURP. I was under general anesthetic and remember nothing. St. Luke's was amazing (although the hospital needs a lot more nurses as it takes forever for a nurse to arrive after pressing the call button). The 3-way catheter inserted after the TURP was irrigated for 48 hours to flush the TURP waste and blood from my bladder, then removed after 3 days. I opted to stay in-patient for 2 more days after removal because I really didn't want to risk needing to rush into the ER after midnight if there was a problem.

It's now 11 days since the TURP. At first, I had some pain, but only 3 – 4 on a scale of 10 when urinating: now I have no pain. The past 3 days I have had some slight blood in my urine as the scabs from the TURP dissolve and fall away but it’s getting less. At first, I needed to urinate every 20 - 30 minutes and could not stop myself if I didn’t reach the toilet within 10 seconds. Now I still need to urinate more frequently, but the worst of the initial incontinence seems to be over. Best of all, my urine flow is strong, probably as strong as it was when I was 20.

The total cost of the TURP at St. Luke’s, including private room, doctor and anesthetist professional fees, and all medicines, was PHP324,000. The best money I ever spent!    

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  • Posted

    Wow,what a experience. Was that 324000 us dollars.

    Just got my mayo bill for $34,000 and $11000 for doctor not to mention a few thousand for anesthesia.

    I had a Holap which is a laser to core out prostate. At Mayo in Scottsdale AZ. On July 14th 2017.

    My responsibility should be ^ 4000.

    My prostate was only 38cc but plugged up, pretty good.

    Wore pad for 1 week but never any blood. 1 accident day 6 with involuntary urination while on hike at Monozuma castle.

    Been 3 weeks and gaining great control .Had sort of sore penis at tip and doc put me on antibiotics, cath may gave me slight infection by cleaning up now.

    Had sex 2nd week and felt less than before. However pee like a teenager.

    I still have wet ejaculation but less fluid than before. Am able to sleep longer at night, 6 hours one night but about 4 if I keep water bottle at bed stand.

    Seem to empty most time and getting better.

    Hope you have a good recovery also.

    I'm 62. So am putting BPH behind me.

    Hope we can live with peace on our decision.

    I'm 3 weeks out so I'm sure you will notice the improvement as time passes.

    Wish you luck

    Paul

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    • Posted

      Hi Paul,

      P324,000 is about US$6,450. $45,000?? I thought my bill was high but now I realize how fortunate I was.

      The incontinence is irritating but it's improving daily. I'll try a visit to the mall tomorrow to test my holding power.

      I also had some soreness around the tip and am pretty certain it was the catheter..... catheterization is one thing I won't miss!

      Happy recovery

      Chris

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  • Posted

    Salamat, and hope your TURP lasts a lifetime.

    I'm still on Finasteride for my BPH - waiting for some better solution to come along.

    1 peso = about $0.02 US I believe. 

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    • Posted

      Hi Vibes, how long have you been on finasteride ? Any bad side effects ? I just started 2 months ago. Just like you, waiting for a good procedure. Hank

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    • Posted

      Hello Vibes,

      I was on Finasteride for two weeks, also Fozal, but it had no noticeable effect on my urination and I had a AUR within 24 hours of catheter removal. Also, I read somewhere about an FDA warning that it might lead to a greater risk of undiscovered prostate cancer because it reduces the PSA levels that doctors rely upon to determine the presence of cancer.

      Although medical techniques are always improving, I decided to go ahead with TURP now because otherwise I would have faced a life with a catheter while waiting for a better option than TURP. That option might not emerge or might be too expensive for me to afford when it does. At present I'm glad I made the choice but I'm fortunate that the TURP side-effects have not been too bad.

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    • Posted

      They say a Turp can lasta  good 10 years but there was a man on here that had 3 TURP in 10 year his prostate keep growing.  That is a rough surgery to go through once but 3 timp.  No way buddy  Ken 
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  • Posted

    Chris  I am sorry for your problem. But I would have waited till I got back home.  I would not have had a doctor I don't know do anything to me.  I have a good Urologist Turp is the worst procedure you can have and it can take up to a year to heal.  I am a very stubborn man and no one would ever do that to me.  With your age a laser procedure would have been better for you less bleeded and faster healing.  With turp to many side effect to deal with.  Worst is retro.  Why should I have to give that up to just pee a little better.  Some men are talked into it by there doctor and after they are so depressed they give up sex all together because it is not the same.  I had somewhat happen to me but I was at home.  Had the retention bleeding and bladder spasms.  Could not pee at all.  Had to had a catheter in to flush me out but still was bleeding.  I had to have emergency surgery to find out way I was bleeding.  It was not my urologist so I would not give permission for surgery until he sign a paper that my prostate would not be touch or cut in anyway.  It took him 30 minutes to sign and have it witness.  It ended up being 3 blood clogs he burn them and all is fine.  I hope you recover fast what done is done.  I just hope your happy with the out come.   Have a good day  Ken

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  • Posted

    Been there done that I could write a horrendous story of all my bad experience of lock up and rushing to er to be cathed friggin differed fir years and thought it would go away or improve' not! No vitimans screw that did not take the meds I was prescribed finally figuring out no cold medicines alcohol an caffeine made it worse damit I should have sought an expert 5 years earlier. My downfall really kicked into gear after I was permanently injured in the job in 13 may, shoulder surgery oct, three days after surgery tore my colon not being able to poop but though it was just hemorides misdiagnosed for a yr n half by a specialist then it healed enough to no pain while forced through therapy tore it again back to quack who admitted he missed it, fired him An his wife my md An got new specialist he fixed with surgery sent me home 7 hrs later bladder lock back to er in pain beyond words thank god right in cathed 660 mil out An there is where my prostate went to hell  after a couple more lick ups An er nitemares my urologist said u ready to fix it? Next day Turp home back to er three days later pain in my bank right rib An fever another 5 days in hospital every test Ct scan antibiotics IV pain meds IV they figure ribs damaged being rolled over and off operation table to bed, now 48 days post one bladder infection  and very slow recovery but doctor says man I removed from a huge prostate in a 1.5 hr operation lots of flesh take it easy no sex no booze no coffee all if you want to heal correctly and take it easy not uncommon to take 4-6 months I use ice bags heating pads and hot baths Tylenol and Xanax as needed have narco but don't use it is physically and mentally tough but I pray I am getting better 

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    • Posted

      JOhn why all of a sudden Turp is the fix all.  With all the other surgery you had that what cause you the problem.  Was this all in the same hospital. I had a 9 hour ablation for a-fab.  Had a catheter in took it out they told me that if I did not pee in 4 hours they would have to put it in. They try to do it and I would not give them permission.  It took me 12 hour to pee 50cc.  THey still try I told them no way.   I would have waited and looked into something else.  Let me heal from one before you start with another.  Hope you can deal with all the side effect.  You do know all men heal at a different rate.  It could take you up to a year...Good luck  Ken
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    • Posted

      Ken my problem had been going on since 23 years old I had a huge

      Prostate huge!'m and I have struggled for years to pee but earlier in my 30's the urologist had no clue how to fix no drugs hot baths and masterbate more is Turp a fix all??!!  Bud I hope the fk so if not well who knows

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    • Posted

      Hi Ken and John,

      TURP is not a fix all and if the Fozal and Finasteride had worked for me, I would not have had the surgery.

      I guess I could have kept on the drugs for another couple of weeks and tried another trial removal to see if I could urinate without a catheter, but the first failed removal was enough to convince me that I didn't want to spend the rest of my life worrying about when I would next need to race to the nearest ER at 2am and have a student nurse or doctor use me for catheter insertion practice smile The alternative would have been continual catheterization which would have given me a lower quality of life than suffering retrograde ejaculation.

      Anyway, with 8 children already, maybe less sex might not be a bad thing for me!

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    • Posted

      Chris.. Don't take this the wrong way but you said it yourself   TURP is not a fix all .  So why have it done and done my a doctor that you only met once.  You let you sumptom pick your procedure.  That doctor got you at the time right to talk you into a Turp .  You could have done CIC or even a condom catheter till you got home and had something done states.  At your age I think a Laser procedure would have be much easier for you.  Has for retro.  I don't care if your not having anymore kids you should have not had to give up anything just to pee better.  And you let the doctor make that choice for you.  Did you even talk with your wife.  It's to late now whats done is done.  I hope things get better for you and you are happen with all the side effects that comes up to deal with.  A turp takes sometimes a year to heal. Good luck  Ken   

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    • Posted

      Ken,

      you should learn copy and paste, because you always jump on the TURP guys and procedure. These guys are happy with what they had done, why are you p*****g on there Cheerios?

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