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Turp operation or laser ?or leave alone?

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graham30431
graham30431

Hello there I am 59 years old, I have been diagnosed with bph for several. Years now , psa ok around 2.5 checked every year, symptoms getting worse, peeing several times during the night , also severe retention if leave it too long when need to go .do not leak! (Yet) and would appreciate feedback from others who have had the procedure ( good and bad) The alfuziin 10 mg tablets seem to make little difference, and wondering whether to go ahead or carry on.

6 likes, 975 replies

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  • jim31207
    jim31207 graham30431

    Posted

    Finally got that darn catheter out of me yesterday morning.  I would have to say that my operation was a success. The flow is great.  What I have to learn is how to control it until my bladder relearns that it does not have to open the dam. As has been mentioned by others, when I realize I have to go, I have to head for a bathroom because I may not be able to hold it all back. I also have experienced what I have read other men mention, the confusion between needing to urinate and needing a bm, particularly as I have experienced constipation unlike I ever have ever had.  I was on the steady retinue of stool softeners and laxitives.  Yesterday my Urologist's Head nurse recommended I get Magnesium citrate and drink that which I did and it finally worked.  Later in the day I felt the strong urge to urinate or so I thought and I ran to the bathroom and could not-I got out a little bloody water and began to panic thinking I was blocked. I then realized that I had confused the two. Within an hour or so I then knew I had to urinate and it came out fine. I am having very little of the burning.  Drinking many glasses of water a day is absolutely vital.  Very little blood at this point, but I do know I will see more and pieces of matter flow out of me over the next few weeks. 

    The only complication I have had is a very painful flareup of gout.  I am not a drinker and avoid those foods that contribute to uric acid buildup but the attack came on with a vengeance Sunday. Disappointing to me that I finally got the catheter out only to have the gout hit me. The nurse told me I could take Advil, but be aware it acts as a blood thinner.  I tried to read some articles of gout attacks immediately after TURP and can't figure out yet if there is a corralation.

    Going through the surgery, a week with a catheter and seeing all the blood was hell.  But to know that now for the next decade or more I won't have to go to the emergency room to get a catheter or learn how to regularly use a catheter on my own more than offsets it. I will be able to travel without being anxious-planning on going to the UK and France in the Spring. We had planned to go this Fall and I was extremely anxious about that-wondering what would happen to me if I got Urinary retention while on the plane or while in Europe.  I am glad I had the TURP thus far. 

    • kenneth1955
      kenneth1955 jim31207

      Posted

      I'm glad your doing good.  Let's help it stays that way..Good Health my friend  Ken
  • jim31207
    jim31207 graham30431

    Posted

    What a  difference a week makes.  I am miserable.  Frequently when I start to urinate, blood comes out, then the urine. It hurts to begin urination, It burns afterwards. Many times the tip of my penis itches. Last night I think I got up every hour and a half to go to the bathroom.  Zero, and I mean zero interest in sex (not that I would at this point anyway as it is only 2 weeks since the surgury).

    I had my follow up with the Urologist yesterday.  I thought for sure I had an infection, and when I left the sample it was very dark.  The Nurse told me there was no indication of infection, and only microscopic amounts of blood were present.  She performed a  bladder scan and said I am doing an excellent job of emptying it.  She told me everything I am experiencing is normal.  I had a terrible gout attack for which I took 4 advil a day for several days, and she said the combination of the gout and advil probably has aggravated my body a bit. I also told her that I dreaded going into the bathroom now- the discomfort of getting it started and then the aftermath made me apprehensive each time I needed to go. That of course is a mental thing but it affects how I feel. She told me my interest in sex would return.  After my consultation with her she spoke with the Urologist who came in a few minutes later, shook my hand and said "edema" . She looked at me and said "you have inflammation, scabs, and irritation". She told me it is part of the healing process and that it is going to be this way for 6-8 weeks. She told me I will see blood off and on the full period.  I am going to be sore and uncomfortable, but that it will get better. Lord I hope so.  The stream is ok.  Praying I look back on this two months from now and am very satisfied and can say going through  this was worth it.  The way I feel today, not feeling like that right now.

    • bob120
      bob120 jim31207

      Posted

      Hi Jim,

      Sounds like the aftermath of my Green Light 180 watt laser in 2012. Took 9 weeks to turn the corner. Had bleeding for 6 weeks. Eye popping pain at the start and end of urination for about 9 weeks. Urgency that gave me about 4 seconds to get to a bathroom, and frequency of about once per hour around the clock. This is what they call the healing process. I ws corresponding with a person who had the holmium laser and another who also had the green light laser and they had the same symptoms for about 8 weeks.   The aftermath of my second greenlight laser about 18 months later was not as bad, and my turp 16 months after that was the easiest recuperation and only lasted about 5 weeks with much less pain but similar frequency and urgency. Maybe I became desensitized after the two previous GL surgeries, or maybe the turp was easier on me. At any rate, hang in there. I'm pretty sure you will be much better after 8-9 weeks post the turp.

      Bob

    • bob120
      bob120

      Posted

      P.S. The only effect on my sex life was my wife was afraid to touch me. I had to fly solo the first couple of times to assure her she wouldn't cause any damage. Maybe it was two soon, but I only lasted a couple of weeks after each of the surgeries.
    • kenneth1955
      kenneth1955 jim31207

      Posted

      I think you should have been done with the blood all ready. Drink alot of water I hope it goes away soon. Never read that on here before after that take care ken
  • jim31207
    jim31207 graham30431

    Posted

    I am feeling a lot better.  Definitely drinking lots of water is mandatory. This morning not feeling the nagging burning I did through yesterday.  

    My sex drive has come roaring back, and I mean like now. I intend to wait at least another week or two before I attempt to ejaculate so I can be as healed as possible.  I want to try and minimize pain.  I have made the mistake of reading a lot of forums where men discuss retrograde ejaculation so I can prepare myself for that first time.  Several of the forums had countless men talking about suicidal thoughts and how it had ruined their lives and how they wished they had not had the TURP or whichever procedure resulted in it.  I just can't imagine thinking having a catheter inserted frequently, trips to the emergency room and eventual damage to the kidneys and/or bladder is better than not seeing semen. No one really discusses how the orgasm feels or sensations, so I don't know what to expect. Still, being able to have a normal life without urine retention and worrying about travel etc. seems invaluable to me. 

    I am very appreciative of the feedback and sharing of experiences I have found here.  It helps enormously.

    • kenneth1955
      kenneth1955 jim31207

      Posted

      Every man is not the same.  You did what you felt was right for you.  I don't remember reading how old you are but to feel better and still have some fun is still ok.  I was on a pill don't remember which one but it cause the dry orgasm.  It was ok but hurt in the bladder for a while.  Was uncomfortable. Let's say it's allmost the same to a pointe.  And you know the more you wait the stronger it will be.   I had a Uro-lift in April and still going strong.  We have to do what is best for us.  Take care and I hope it great for you  Ken    
    • tim07875
      tim07875 jim31207

      Posted

      Hi JIm,

      Looks like this was posted a couple months ago, but what the heck. Prior to my TURP, me sexual experiences were downright painful. Ejaculations burned badly. After the TURP, that burning is gone entirely.

      My surgeon discussed the dry ejaculations with me beforehand. I'm not sure why some guys somehow measure their manhood by semen? In my case, I was thrilled to have a pleasurable sensation back without the burning.  If you're thinking of having a family, different story.  I can honestly tell you that the climax sensation, in my case, is identical pre and post surgery .  

    • kenneth1955
      kenneth1955 tim07875

      Posted

      I'm glad your one of the lucky ones.  I had dry orgasms with a pill I was taking.  They were very weak and did not care from them. They hurt my bladder for about a hour.  To me they were not the same and did not like them.  I tryed to avoid sex until I got off the pill.  Had a urolift in 2015 all is great and no side effects.  All men are diffrent.  Ken
    • wally5
      wally5 jim31207

      Posted

      Im one of those people who are totally unhappy about the fact that my urologist have told me that the sex and the feeling will be exactly the same after the TURP . Its definitely not the same in my case and in fact the climax is not even remotely the same. In fact it is so pathetic that my sex life is a total disaster now. The worst is that My urologist can say with a smile on his face that I must get myself another urologist and that research make it possible for him to tell a patient that the sex will feel the same and even after all the complaints on the internet he can still tell these lies as the "research" will be a save reason for him to tell that to all his patients. What I cannot understand is that now that I went to another urologist, he cannot understand that a urologist can just tell a person about the Turp and no other option and he also cant believe that a urologist dont know about all the unhappy patients. I dont deny the fact that there are a lot of happy people but Im sorry there are unhappy people and somewhere we should be able to tell people about it. Nothing could be more disasterous to me than to realise that I will never have a good climax in my life again and believe me , 5 years after the TURP and I never had a good one.
    • kenneth1955
      kenneth1955 wally5

      Posted

      They will tell a patient anything to have it done because that is money in there pocket.  I cannot say that there are men that are happy with there out come but I think there are more unhappy men out there then they talk about. Sometime I would like to ask them if they would do it.    Some urologist are more by the book and they feeling are not for there patients.  They will also tell a man if he has prostate cancer and has it remove sex will be the same but what he does not say is that sometimes it will take 2 year if you ever get it back and it will not be the same.  I have read on here that there are some urologist will have there patients try a pill that will cause them retro orgasm to see if they can live with it and to see how it feels.  There not as intense.  Had them did not like them.  You have to have trust your urologist because your life is in his hands...Ken   
    • steven43881
      steven43881 wally5

      Posted

      Amen, Wally  I simply don't trust many Urologists anymore! It's a terrible profession as far as I'm concerned. For a human being to do that to another human being. The Good Lord see's all this, though. Believe me!
  • tim07875
    tim07875 graham30431

    Posted

    Graham,  I'll give you my thoughts. Had a green laser done about 10 years ago. I do think at that time, I was one of the first to have it done here (Phoenix, AZ) (more on that in a minute).  Had a TURP on October 13, 2015. Typical TURP. My surgeon said that  during the usual TURP he removed about 10mm of tissue. Mine was so enlarged, he took 50mm. No big deal. Catheder/hospital overnight, was peeing ok, so they released me the following day. Quite a bit of blood while peeing for the first 10 days or so, and the urgency was very immediate, so be sure you're near a bathroom for the first couple of weeks. It took me about 70-80 days to the point where I could hold my bladder very well and not be running for a bathroom the moment I stood up. I never had the leakage issues while coughing or sneezing. Now, I'm 4 month post-surgery and all is well. I pee like a teen again, and my bladder empties totally.

    Couple of side notes. Post surgery, peeing for the first month or so is pretty painful., the first 2 weeks you'll be peeing on your tiptoes as it burns, especially at the end. This slowly goes away. Also, for the first few weeks post surgery, while you've emptied your bladder totally, it still "feels" like you need to go. You'll try, nothing happens....ok. Now, I pee once in the night. Nice. 

    Regarding the laser mentioned earlier. In my case, I did not get any relief from this procedure. In fact, after my TURP, my surgeon mentioned that he needed to take an additional 45 minutes on the table removing the scar tissue from the laser procedure. The good news was that the first surgeon removed so very little tissue during the laser (I was told that he was very new to the procedure) he was being overly careful. In retrospect, I'm glad this occured as had I had a ton of scar tissue, who knows?

    I am thrilled with the result from my TURP. Everyone is different, and this venue has its share of guys who have not had a good experience. I think alot comes back to the doctor. When I asked my doc "How many TURPS have you done"? He said he'd been a urologist/surgeon for 22 years and done a couple thousand over his career.  

    Right now, I'd say I'm at about 90% full recovery. No more pain wjhile urinating, no blood, and I can hold my bladder comfortably for about 4 hours now, compared with 30 minutes.

    Best of Luck.

    • kenneth1955
      kenneth1955 tim07875

      Posted

      Hi Tim.  I'm glad that all is going well for you after 2 procedures.  How old are you.  Did you have any throughts about any of the side effects from  the laser or the turps or you did not care about the side effects  Ken
    • bob120
      bob120 tim07875

      Posted

      Hi Tim,

      Glad you are doing well. Your experience with the GL laser and the turp very much mirror my own. I had two GL lasers and finally a standard turp last April. For me the turp was superior in every way to the GL laser turps. The results were better and the recovery easier. I also bled and was in pain for 6 to 9 weeks following each of the procedures.

      My enjoyment of sex was also not diminished in any way by the retro which I got for the first time after the turp.  I was so worried about it, but it was a non-issue for me. 

      You mentioned scar tissue from your laser. I had another side effect, two serious hematurias about a quarter to a year and a half after each of the two GL laser turps. Both needed hospitalization, surgery and blood transfusions (8 pints on the first and 6 pints on the second).

      Also, it seems my prostate grew at an incredible rate after the laser treatments. I started off with a 100g. prostate, and 18 months later it was 300g, when I had the second laser for the hematuria. My uro also removed bladder stones and resectioned the bladder neck on that second GL.

      About a year and a quarter after the second laser my prostae was 300g. again. Another hematuria and a standard turp this time.

      6 months after the last April's turp, I asked my urologist for a sonogram to measure my pvr and the current size of my prostate. My prostae was 200g. I asked him why it was growing back so fast, he had no answer.

      I started taking dutasteride (generic avodart) about 3 months ago hoping to shrink it more and keep it from growing back. I'll check it again in another 3 months. The dutasteride seems preferable to getting a turp every two years, but I may have to take it for life.

      I'm 69 and recovery from the turp was good, but the fatigue of being hospitalized, having the surgery and the transfusions, is still with me almost a year later. It took more than 6 months for my red blood cells and hemoglobin to get back to normal and I'm still low on iron.

       It's a shame we have to learn these things on our own through experience.

    • kenneth1955
      kenneth1955 bob120

      Posted

      Bob I am glad all is working out for you.  But why have a turp or laser and go through all of that when something less evasive may have work with less truma.  You could have died.  Ken  
    • bob120
      bob120 kenneth1955

      Posted

      Good question, The answer is that nothing else less invasive would have worked. A year prior to the first GL laser I had the less invasive TUMT (microwave probe heats up and cooks some of the obstructed prostate). It was pretty much a waste of time. The recovery was two months long and the positive effects evaporated at the 6th month.

      The first GL was less invasive than the standard turp. My prostate was over 100g. and I had a large median lobe protruding into the bladder. The urolift was hardly known in 2012, but even today, the size of my prostate at over 100g. and the large 40g. median lobe protruding into the bladder would disqualify me from that procedure. 

      The second GL laser 18 months later was to stop uncontrolled bleeding from hematuria of the prostate. At that point my prostate size was 300g. including a 25g median lobe, still protruding into the bladder. I needed 8 pints of whole blood transfusions. During that GL my uro stopped the bleeding, removed parts of the prostate and bladder neck that were the bleeding sites, resectioned the bladder neck and removed bladder stones. I don't think any less invasive procedure would have done all that, and especially not in a 55 minute surgery. On my turp 15 months after the second GL, my prostate was back up to 300g. I again had uncontrolled hematuria, and needed two surgeries to stop the bleeding and remove blood clots completely covering my bladder walls. The turp removed the remaining median lobe so it no longer protruded into my blader and brought my prostate size down to 200g.

    • bob120
      bob120

      Posted

      P.S. Kenneth. If I had it to do over again I would have first tried the dutasteride I am now using for the past 3 months to shrink my prostate. So far I've had none of the possible side effects (man boobs, muscle weakness, etc.). Back in 2012, my first GL laser was advertised as a permanent solution, that would make it possible to avoid using medications. That turned out to be totally untrue in my case. By the time I got my second GL at the end of 2013 and the turp in 2015 as emergency treatments to stop the uncontrolled bleeding, it was a matter of life and death. During the first hematuria I crashed in the hospital when my hemoglobin went down to 6. In those situations you don't have the time or ability to discuss options.
    • tim07875
      tim07875 kenneth1955

      Posted

      Hi Kenneth,

      I am currently 62. Had the laser at 52. I had worse side effects from the laser than the TURP to be honest. Bleeding went on for months, passing large blood clots daily, in fact 2 years later I suddenly began passing blood again. Urologist did a cysto and said I had formed some "crystals" on the prostate which were breaking away causing the bleeding> Huh?.

      Always concerned about side effects, and I believe I did my homework before agreeing to the TURP. Prior to surgery, I could never fully empty my bladder, urination at times was painful, I couldn't sit through a full length movie without getting up at least once or twice. After the TURP, the urgency is gone, when I urinate, my bladder is empty. When, in the past, I would never pass a bathroom without stopping in, today, I walk right by. No side effects, no regrets.  Maybe I'm one of the lucky ones? 

       

    • kenneth1955
      kenneth1955 bob120

      Posted

      Glad they were able to save your life.  But the doctors need to get with something other then the turp or laser.  I have read on here that there are many men that have to have the same thing done over and over again.  The body can't take that. losing blood and the other stuff it causes.  I hope your doing better now.  Ken
    • kenneth1955
      kenneth1955 tim07875

      Posted

      Yes tim I think you are one of the lucky ones.  Maybe they need some improvement in both the laser and the turp procedure..  Take care  Ken
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