TURP in Manila
Posted , 11 users are following.
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!
0 likes, 30 replies
hank1953 chris0301
Posted
grant75607 chris0301
Posted
kenneth1955 grant75607
Posted
grant75607 kenneth1955
Posted
kenneth1955 grant75607
Posted
jak10 chris0301
Posted
May I check how much was the urologists PF? thanks!
lyndon30021 chris0301
Posted
Hi Chris,
Hope you are doing fine after your TURP operation. I was wondering if, since such an invasive procedure, are you now reasonably free of the typical BPH symptoms and would you expect no further prostate interventions in the future ?
Can you offer any advice on minimal invasive prostate procedures, namely the heat shrinking and urolift methods, which apparently have provided good results without any notable side-effects ?
I am most interested in your post operative management, that is, are you pleased with the overall result of your TURP op'.
Thank you for your time, george.
kenneth1955 lyndon30021
Posted
Good morning Lyndon.
I wonder why he had a Turp I do not think they offer anything else there. Turp can take a long time for some men. They have to deal with a lot of side effects. Let hope he does good with his. My urologist calls it the last resort procedure.
With the minimal invasive procedure there are less side effects. With the Rezum it can work for you or it may not. Also the odd of retro are 10 to 15 %. With Urolift there are no side effect at all and no cutting they just pull it apart and clip it open. That one would be the best to start with if you have a prostate problem
Good luck Ken
lyndon30021 kenneth1955
Posted
Hi Ken, hope your urolift procedure is holdin' out well ! It is difficult to decide on most options available, esp. owing to limited statistical evidence for their overall efficacy. I guess urolift is attractive though, since no apparent lingering side-effects, however it's a costly opt as I don't believe there is any Medicare coverage in Oz. At a glance, not many convenient venues appear to be available for the urolift procedure. Since the damn prostate does not call it quits, and continues to grow throughout life, it's questionable though of the effective duration of this method. But if you had say, no issues for 5-10yrs, and later needed a definitive procedure like a TURP, you would have done quite well indeed, considering low or no sides for all that quality time ! I noticed that the minimal invasive rezum system that heat shrinks the prostate or PAE may incur side effects, unlike urolift proc. Rezum is apparently about half the cost of urolift. So with all the dubious options available, any wonder that it's hard to know which course to take. Everyone is different, and it seems some will always encounter disappointing stormy weather along the way with any one type of procedure done, whereas others with the same will enjoy seamless smooth sailin' ! Although I am noticing a hesitancy in ejaculation, I could be bordering on the onset of retrograde symptoms, although urinary function is manageable at present, without the use of drugs. Since this is the case, it may therefore be worthwhile for me to wait meantime, until perhaps existing treatments become more reliable, with only minor sides, or even further newly discovered radical techniques that offer even more hope for this common debilitating and life-changing disease. cheers!
kenneth1955 lyndon30021
Posted
Hey buddy.
I hate to ask a stupid question what is Oz. Were are you at. I live in Orlando Florida and I have WellCare which is like Medicare. I only paid $200 for the surgery center or co-pay.
It is really a shame when you can't get the procedure you want and have to pick one only because your insurance will pay for it. That is not right.
With any prostate problem a man should start with the procedure that give you the lease about of side effect and the quickest heal time. Which is Urolift, Rezum and PAE. The last resort is a Turp if all else fails. That is what my doctor calls it. They do very few. I think he told me that him and his partner have only had to do 3 this year.
Please do your research into anything you are thinking about A man should not have to give up anything just to pee better
Have a great day............Ken
lyndon30021 kenneth1955
Posted
Ahh, Oz is the nickname for the land downunder, Australia. As for Medicare, they will cover a TURP at a public hospital but you must be prepared to wait your turn, esp. for urgent cases taking priority. Also, some of the newer procedures, like Urolift or Rizum are not yet approved for Medicare cover and it can take time before they qualify. I am still investigating this anomaly.
Yup, I will do more research, since I really want to avoid repeat treatments which can be debilitating, not to mention further inconvenience and costs involved.
The FLA, Green Light and Cyber TM Thulium Laser used for BPH surgeries indicate a higher level of permanency, with minimal side-effects compared to TURP ops. They have shown to be quite effective, safe, painless and fast. This is generally bloodless surgery with minimal risks involved. Not sure about the costs involved, but is usually done as outpatient surgery or an overnight if desired, for peace of mind.
As previously said, many recently established procedures require at least some years of statistical data in order to gain merit and wider acceptance, which in turn assists one in making a better informed decision.
Wasn't there a devastating hurricane near Miami, Fl. earlier this year ? I seem to recall something like that in the Caribbean and Texas got hit too prior to that, massive flooding. A very dangerous neighborhood to be sure ! Although Australian, I also live in the Philippines too where typhoons roar in from the Pacific, whereas those hurricanes move in from the Atlantic, right ?
Anyhow, all the best with your urolift procedure which I assume you had a year or so ago.
kenneth1955 lyndon30021
Posted
Lyndon
Thank you for explaining that to me. I guess your Medicare symptom is different then ours. Medicare did approve the Urolift in the US years ago. It will be 4 years in April of 2019 for me.I think it was also approved in the UK with NICE I think last year or the year before.
Urolift has been around about 9 years that is with the 3 year trail that they had. At the start of this year they started a trail on larger prostate and median lobes. That will help many men that do not want to have a surgery that will cut out the prostate.
I hopw all works out for you. God Bless........Ken
hera_landers chris0301
Edited
Hello, Chris. Hope this message finds you well.
I would just like to ask how are you now after the TURP surgery you had 5 yrs ago? Is your urination still getting better? Is there a possibility for another operation (hope not)? Any response would be highly appreciated.
I am just looking for some relevant experiences about the operation and found yours here. My father, 55 y/o, was recommended by the doctor to undergo TURP because he got about 53g volume of prostate gland and had a hard time peeing one night. He also got cathetered just like what you have shared, but for him it's only once. Currently, he is kinda worried about the post surgery effects, so he just continues with his Finasteride medication for 3 weeks now.
We are also living in Manila and looking for great and affordable hospital for the surgery. Looking forward to your reply (and might as well from others who could share their post TURP experience). Thanks!
Hera