TURP in Manila

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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