Turp operation or laser ?or leave alone?

I see that there is a great deal of discussion here about the TURP procedure.  I struggled with what to do for many years.  I found that reading entries on this site was very helpful to me.  For one thing -- simply to see that a lot of other guys were having the same problems (difficulty urinating, having to get up many times during the night, various accidents, etc.).  Also, to gain insights from what others have experienced in researching and grappling with the same issues.  For that reason, I wanted to include my $0.02 here, in the hopes that what I say might be helpful to others -- even if somewhat inconclusive.

I am 64 years old, in pretty good health.  I have followed the same path over the past several years as many others.  Various medications.  The best there for me was the combination of Tamsulosin (Flomax) with Finasteride.  That alleviated my BHP symptons.  The problem with that, though, was that it left me feeling low energy and mentally dull.  Ultimately, I chose to go forward with the surgical procedure.  

Part of my decision to do that was based on the indication here that some of the more recent technologies (button turp, for example) are less harsh on the body.  That led me to suspect that treatments might now be effective, but less of an ordeal.

In my situation, though, I am a member of a U.S. HMO.  Yes -- they work with the newer technologies.  But the main urologist is accustomed to doing traditional TURP (the "loop").  They also favor the more aggressive treatment because they believe that it lasts longer.  (My urologist:  "Let me make the decision about which technology to use.")  The urologist gave me the option of getting another opinion.  I did that.  But the other opinion, was from another less senior urologist in the same group.  Not surprisingly, he was supportive of his superior.  He characterized the button as attempting to do with "sandpaper" what one might do more effectively with a carving tool.  

I don't think my experience was unusual -- but it turned out to be more of an ordeal than I anticipated.  Yes -- they planned to keep me in the hospital over night to make sure that it was all o.k.  In fact, I had the surgery around noon on one day.  Lots of bleeding and clots blockinig the catheter during the night.  They did a major flush of tissue and clots the next evening, before releasing me from the hospital with the catheter in.  In retrospect, I don't think they should have even released me then, because I had to go back in to emergency twice in the following two days to clean out the clogs.  

The other complication that came up for me was that about three weeks after the surgery (well after having the catheter out), I had another major bout of passing blood and clots, which put me back in the hospital for reinsertion of a catheter and another overnight stay.  My suspicion is that the reason for all this was that the initial treatment they did on me was very thorough.  Long term the result will probably be a longer time before I might need to look at having the procedure done again.  In the short term, though, it meant more blood, more discomfort, and more delayed recovery in getting fully back on my feet.

Now, about 5 weeks out, I have no visible blood in urine and strong easy urine flow.  I still need to get up several times during the night -- but I am hopeful that will diminish over time.  During the day, I am not having problems with urgency.  My energy level is still subdued, though.  

Like other comments I have seen, over time I suspect I will be glad that I went through all this.  In retrospect, I think that in getting another opinion, I should have been more aggressive about consulting with a specialist who was truly independent of the HMO team where I was looking at having my procedure done.  I don't think that there was anything particularly unusual in my situation.  Would the button turp in fact be as effective over the long term as the loop?  I don't know.  Using the technique they did, there was the benefit that they were able to obtain a biopsy on my prostate tissue (it came out negative).  Another question one might consider:  even if the button procedure doesn't last as long, if the experience is a lot more mild, might having to go back in for another procedure after only 5 years (vs. 10 years, say) still be preferable?

That's pretty much everything I have to say about my experience here.  I am sympathetic with anyone who is grappling with the same issues.  I will say that all the personal care that I received from the HMO throughout the whole process was very sensitive to me and my situation and was top notch.  Having a partner by my side to help me through the whole process was an invaluable benefit, as well.

 

Hi there, i have to say that i am recovering from TURP op 5 weeks ago.(sat 21st march). My problem came to light on Aug 1st last year in the form of a UTI, which after 21 days of ciprofloxin and others cleared up!! however, the symptoms of reduced flow, and discomfort while peeing, and  variable night time urges continued. Diagnosed with BPH........after exhaustive tests(flow meters scans ,and DRE) all done twice at least,recommended  for turp! I did do research into various techniques....Laser the usual, and newer tech`s, but on balance went with the standard procedeure. this was because the other alternative treatment involved travel, overnight stays in hotels!! etc etc, and our local hospital did the turp every day,and the surgeon "doing " me was over 500 ops!! So off i went, the op(spinal aneasthetic) went well, catheter removed 24 hrs after!!      peeing immediately(painful for several days),and after 1 week no blood,just occasional BITS of debris !I am 67 and ex pro Squash player and cyclist!!on release was told "take it easy for 2 to 3 weeks!!!!!"and that was it, the follow up paper said the same and no heavy lifting!...so i have done that,, just walking for exercise,,   i have now been on the bike a couple of times for no more than 50k`s...So i have noticed that>>>>>>i now have a stronger flow( i have to actually aim and be careful where i point!!),no pain while peeing,just a 30sec to 1 min discomfort after pee. depending on amount of fluid intake after 9pm depends on how often i visit toilet during sleep hours !. my log shows average 2/3 times a night. I have to say during day prob every 2-3 hours(depends on intake) i try to hold on as long as i can.....then i have to go or would wet myself!!.cycling( ihave changed all my saddles to split design(selle SMP) and this does help,in fact when cycling my mind is on other things and i feel i go longer between stops.. It was discovered that my problem before op was obstruction at neck of bladder, and the prostate was normal!! However surgeon did say that i was going to get 2 for the price of 1!! the prostate rebore would happen anyway. To sum up i would recommend the turp op ..however after talking to other (users) the green-light laser method gets slightly more votes.   Bear in mind the travelling and re-visiting costs and difficulties..Also the hospital feedback scores!! I was worried recently about my discomfort after pee but my wife reminded me of the dreadful feelings i had before op!!! and hav ing read this forum with tips and experience`s, i feel all will be ok in the near future. As to sex, no problems there except intial retro ejaculation(after2 weeks) to a dribble at the moment. actually i don`t care as long as no pain or discomfort !! Hope this all helps if you have not yet decided.