Turp operation or laser ?or leave alone?

Sorry thought it was a new person asking what to do - in order to chose between a TURP or a laser.

I have to agree with the others that once they start cutting, you may be in for it. I had a TUMT, a Green Light laser, a second Greenlight laser to stop a hematuria, resection the bladder neck and rmove bladder stones, a removal of a blocking membrane with a cystoscope, a standard TURP to rmove more tissue to stop a second hematuria, and a cystoscope procedure to clean out clots and stop a third hematuria. all in 4 years. With the standard TURP about 2 months ago, I finally experienced retro. The one thing I can say is that I felt no different in terms of the orgasm intensity or pleasure. In fact I had forgotten about the retro and was unable to understand why there was no semen afterwards, as I fully expected there would be. I think it goes to show that there is a wide difference in people and the way they will recover from one of these prostate procedures. One person's experience may be quite different from another's. Unfortunately there is no way to tell in advance as there doesn't seem to be any sort of diagnostic work being done to identify potential problems before hand. I do believe the urologists are also in the dark here to a great extent. It seems like a complete crap shoot for everyone. Sure there are forums like these, but with all the procedures officially claiming a 95% or so success rate, the individual has no way to guarantee anything.

as we discussed before, the 5 - 10% failures need to be examined thouroughly,and poss investigated to best of knowledge.. The 90% success (of which, as stated i am one!) We don`t really know why we are now (eventually) seemingly ok?? in my case 12 weeks to the day! I have no idea what really went on , and apart from the follow up letter stating that none of the removed chips showed any signs of malignancy!! i am none  the wiser... so my advice as to wether yes/no to any procedeure is largely irrelevant !!   Bob can i ask>>>>what happened that a  hematuria cropped up ???  regards all... Syd

Hi Syd,

My urologist said that he thought the hematurias were due to areas weakened by the Laser turps. That would coroborate the theory that once the area is surgically altered it can lead to future problems. Most people with hematurias are on blood thinners or an aspirin regimen but I was on neither. The first hematuria was about 18 months after the GL. I had a couple of drops of blood then no blood for three days, then a full blown hemorrhaging hematuria that instantly clotted and blocked my urethra. After three days in hospital on a 3 way irrigating catheter, mu urologist went in with another greenlight laser to remove tissue, cauterize three bleeders, resection my bladder neck, and remove bladder stones. About 15 months later I again experienced blood in my urine twice in a row. I went right to the urologist who checked my urine and there was no sign of blood or infection. Again, exactly three days later I had the henorrhaging frank blood that clotted instantly and filled my bladder while blocking my urethra. Back to the hospital and 3 way irrigting cath. This time my urologist used the standard turp tool to remove tissue and stop the bleeding. I went home with a cath which was removed 2 weeks later. Three days after the cath was removed, the hemorrhaging started again. Back to the hospital. My uro was out of town so the house uro went in with a cystoscope, cleaned out all the clots and stopped the bleeding. Said I was fine. Except the bleeding continued to fill my cath for two weeks. I was scheduled for exploratory surgery to stop the bleeding when it finally stopped on it's own, the day before the scheduled surgery. After the first hematuria I needed 8 pints of whole blood trnsfusions. After the 2nd and 3rd hematurias I needed 6 pints. The only possible cause I could think of was that alcohol is a blood thinner and I always had a couple of highballs at night before bed. So I haven't had any alcohol in a couple of months. But every time I pee I look down with anxiety until I see the color is yellow instead of red.

Bob I don't think doctor know all what will happy with each person from any procedure. They just pass on the information they have.Most of the time when they start cutting the prostate they say sex is the same but not all the time. A man can have prostate problems at any age. Why would they tell a man in his 20 or 30 that a turp is the way to go. At his age he is still trying to have kids. Retro orgasms are a given with any cutting and most of the pills. I hated them Had them with the pills. I may not have sex as much now but still like to have fun sometimes. Men need to research any procedure before anything is done. Try anything first before cutting because once it's done it over with ken

Hi Ken,

realistically speaking doctors don't have a crystal ball. They know there will be problems with some people but they don't know who. It used to be that 1/10 of 1% of people died from anesthesia. Now medical errors are the third leading cause of death after cancer and heart attacks, and ahead of every other cause of death. That hasn't stopped doctors from treating anyone.

The idea of less invasive procedures doesn't apply to lots of people who have large prosttes. Mine was about 180G. including a 40g. median lobe "the largest prostate my uro had ever seen".  AFter removing 70g. with the GL laser, and another 70G. with the turp my uro says I now have a 40G. prostate which includes a 15G. median lobe. To be fair, I think the larger a peson's prostate, the greater the chance of complications.

Hi, ok ....wow comes to mind. I agree with the alcohol idea, and its not great anyway...Diet is probably fairly important in any case, but again no real professional advice or ideas on pre and post op diets!!    anyway hope you are on the mend, permanently, thanks for all the info,...Syd

Hi Syd,

You are welcome, and thanks for the good wishes.

Bob

Hi i really do not agree. Urologists are proud to perform a TURP on patients even though there exists procedures which are not fancy to perform seen from a doctor perspective but which are very effective and risk free for patients. When we are talking about BPH then it's equal to QOL. When doctors are doing a TURP they are not saving life's but they can improve the QOL. So why do a procedure with high risks when you can improve QOL without any high risks? I only agree if we are talking about procedures where there are no other alternatives or if the procedure can save life. TURP are so last season -

Casper what are you agreeing on. Trup is the first thing a urologist is going to try to get you to do because they have been around for many years. I would never put high risk over a low risk procedure They do work on some men but not on all and if men in there 20's and 30's have them having a child will be over for them. I'm 59 and i would never have one. My urologist gave me many procedures to pick from. Also I have a stricture just before the bladder. The urolift was my first pick to try. If in a few year my stricture get bigger I will have to have a procedure to fix that. They will not cut it out I will have a graft put in. We must pick what we think is right for us. We must live our lives to the fullest because it is short ken

Ken, I agree.  I would weight the risk/benefit ratio of any procedure.  More cutting and burning, more side-effects.  And PAE is outside of the urology field so a urologist won't even offer that.  

Kenneth i do not agree that doctors have to try out before knowing a result. All procedures which are approved either by CE or FDA or whatever have been clinical tested by some other doctors and if I was a doctor then I would never use the "knife" when I am fully aware that I can hurt a patient rest of his life eg BPH. I would always go after the best minimal solution first and try it and if everything does not work then I would recommend the patient to have the surgery. My point is just stop TURP or lasers and doctors should accept that minimal invasive therapies are here to stay eg urolift or memokath.

Casper I do agree with you the doctor should offer less invasive procedure first. The doctor only knows what is written about the procedures. All men heal diffrent and sometimes things will happy to one and not the other...Ken

I know my urologist never said anything about it. He knows the way I feel about cutting away anything. I get as much information as I can Take care Ken

Hi, i don`t know where you live, but in the UK (south west england), i now know that  the no of different procedeures offered to bph sufferers depends on where you are !, i am in N-Devon and was offered nothing but standard TURP, when i enquired for other treatment (laser, urolift , etc) my surgeon/consultant said " i have done 100 or so lasers" have no idea about urolift, and as i am approaching 500 turp`s that is best for you !!"    he added in N;Devon we do not do ant other procedures.... and you will not be offered any other  procedeures anyway!! so there you are, take it or leave it!! My GP also said pretty much the same thing.  As it turns out all went  well and i explained to various users here, i am one of the "lucky" ones... i am back to normal (about 20 years ago normal) i am 12 weeks to the day from surgery, and apart from  not feeling fully confident (mental thing) some times, i am fully active,(67 yrs) cycling, tennis walking, , surfing..etc! having talked to other  bph sufferers from my area, what i have found is pretty standard fare regards operations!! and of course not all are happy with the outcome!! So again i would not recommend any procedeure to anybody based on my pre and post op experience`s  ??  regards and good wishes to all with bph.Syd

 

Hi can I kindly ask which hospital?

Hello I live in Orlando Florida. I think that take it or leave it a bunch of crap. Maybe that is the only training that they have gotten. Thats like saying if there is somthing wrong with my right hand and they only have a left Take it or leave it. Are they that far behind the US that they offer nothing else. I know that the urolift is new but my urologist has done over 100 in the 3 years that it was approved and all have gone well. I am happy that it did work out for you but sometimes it does go bad. Take care my friend and stay healthy Ken

You are right but FDA is not making anything easy for procedures entering US even though a long and huge success rate in Europe. By the way how long time does the doctor tells you the urolift will work and if the prostate has an overgrowth what will the doctor do as the second step?

Hi, yes it  seems that way.     We do have this NHS (national health service ) free treatment, but it would seem that what is on offer depends on your postcode!! (zip code)   it is not the funding, purely geography, but not made easy, and  jealousy within the urologiy fraternity in the UK......the old " mine is better than yours" type of thing !! anyway.... more info will mean more power to the sufferer, and sympathetic treatment all round,  ok, take care out there, Syd

Hi my treatment (excellent as it was ) was carried  out in North Devon at the Barnstaple and North Devon royal Hospital, Barnstaple.     I will say again the whole treatment span was of  top quality,every aspect.  Except my choices of procedeure (nil) and  my release info ( take it easy for 2/3 weeks , no heavy lifting !!) and that was it,  i still do not have a follow up appointment ?? and am now 3 months down the line,(again i was "lucky" with my procedeure and all is well. But it does not fill me with confidence to recommend or otherwise ANY procedeure to another sufferer !!! the i`m allright jack.. will not do when tissue removal is at  stake !! cheers. Syd

Good morning. I did ask him that on my 2 week check-up. He told me the the precedure is new only 7 years and only 3 in the states. The information that he has on the men that had it done 7 years ago all are going great. The implates are very strong.. and he will check every year to make sure that they stay in place ( Scope ) They will keep the prostate away from the urethra and keep it open. If they have to be removed for some reason can can be taking out. My doctor say that they are looking at 10 years or more. They will know more evey year....Ken

Hey Syd. Old sometime does not mean the best. But you would think a doctor would like the best for his patients. Maybe one day they will realise that. Take care. Ken

Why do the doctors over there have this once it done your fine and don't check up on the patients. Alot can happy they what do you do. It's like your just a number. In orlando Anything my urologist did or pills he gave me I always had a followup in 2 weeks to see if it working. If not he changed it. He was great when I had my urolift he saw me before and after to check on me and he was concern. He does that for all his patient and he has alot. He told me what I can do and not to do. He also gave me a list. The healing time was 4 weeks but he would not let me drive to see my grandkids in GA Which is a 8 hour drive. He told me to wait 2 weeks to make sure I was healed Got out for gas and to go to the bathroom a few times. No pain or problem Ken