Turp operation or laser ?or leave alone?

I had a button turp (button plasma vaporization, latest evolution of turp) 9 days ago and following same recovery schedule as your GL so far.   Home same day, catheter 3 days, much improved stream immediately, no pain, intermittent blood in urine.  At this point, happy with the result.  Sleep should improve over time, that will definitely make it a worthwhile improvement to quality of life

Thanks David for sharing. Keep us updated. Hank

Thanks Bill for sharing. Keep us updated. Hank

About 6 weeks.

Hi Bill, how are you feeling now some 3months later ? I was pleased to find this thread as I have been quite concerned at the pain and discomfort I have been experiencing since the op. This thread has helped me to see that it is not unusual and put my mind at rest somewhat. I had TURP op 6 weeks ago and still feels like passing glass each time, however stream is now strong, although short lived, and with a little bit of pushing I can describe a fine parabola of urine something Ive not done for years, as good as sex, lol.  Speaking of which I do have almost dry ejaculation but the actual orgasm feeling is, if anything, better than before and my interest in sex greatly enhanced. I am going back in to to have a large bladder stone removed in a couple of weeks which my doctor says will greatly improve the holding capacity of my bladder, cant wait !

Richard  Did you know you did not have to have a Turp and why did he not remove the stone when he did it.  That is why they do a Turp to make it easier to get the stone out  Why is he putting you through another surgery  Hope all goes well  Ken

Could be the size of the stone or the amount of time he was already under for the TURP. Surgical suites are often reserved for a specific time slot, have to be sanitized and cleaned and other surgeries scheduled later in the day. I had about a dozen (mostly BB sized) bladder stones removed (some had to be crushed first) when I had my second GL laser. But minimal tissue was removed, mostly a bladder mouth resection and cauterixzing some bleeders.

They were going to do both but stone was too hard and large for them to break up mechanically They are going to use laser next time. I did need the TURP, which i am pleased with, except i didnt realise how long and uncomfortable the recuperation pricess was going to be. Seeing others experience on this thread has put my mind at rest. It would have helped if the hospital had advised me of this

Yes that was the problem Bob

They would not advise you prior to the procedure for fear that you would back out.

Richard  I have talk about this with my Urologist.  When you have bladder stones they like to do a TURP because it is easier to get the stones out.  But if you tell them no.  The doctor will just open the prostate up and remove the stones.  Some doctors do not like to do that because it takes more time.  I wish you will and I hope you heal fast  Ken 

That is why when I have any surgery I do not give total control to my doctor.  You do only what I agree to nothing else.  I had emergency surgery was in retention and peeing blood.  It took me 30 minutes to have the urologist sign a paper that my prostate was not to me touch or cut in anyway for any reason.  Have a great  day Ken

Hi Ken, why are you so worried about surgery on your prostate ? I can now urinate properly, not little and often as before, and, as i am completely emptying my bladder each time, will not get another bladder stone. Seems like a win win. All the best

Richard  I am not worried about surgery on my prostate because I would not give them permission to do anything to my prostate.  I had a Urolift in 2015 and I am fine. At 62 I am not ready to give it up yet  Did he tell you that he could get the stones out another way without going through the urethra. There are many other way to do something to help.  But if your happy it's your body and you have to deal with the out come.  Hope the stone removal surgery works well  Ken     

Hi !

I've been reading several if your posts concerning the urolift procedure you had.

I'm scheduled for the urolift in December. Frankly I'm terrified of it since I've been reading about some of the experiences on this forum, even yours! If my understanding is correct you had a subsequent surgery requiring your implants to be tightened up and other repairs?

I thought it looked like a great procedure in the pamphlet and dvd they gave me to watch. Now im not so sure.

I used to get up 10 to 12 times a night to pee. Saw my GP and he started me on tamsulosin which brought it down to 5 times per night.

Had cystoscopy, urodynamics, prostate biopsy (negative at the time) , pelvic floor PT, biofeedback and exercises all since February.

The biofeedback and pelvic floor exercises helped me learn some bladder control and has lessened the tension in my voiding muscles. The urologist thought I had a hyperactive detrusser muscle.

However, the exercises seemed to lose their effectiveness over the last month or so.

I was diagnosed with a nodule on my prostate during a colonoscopy in September. Their checking my PSA next week to see if it's elevated.

I am at the end of my rope with this!

Also, I was diagnosed with obstructive sleep apnea in August and have to use a CPAP!

The urologist agreed to do the urolift to lessen my symptoms and to shut me up. He said it could always be reversed if it didn't help?!

I'm a little concerned that he consented to the urolift since the nodule hasn't been addressed completely.

I suppose I'm being a scardy cat!

Maybe I'll schedule another appointment after my PSA is back.

Getting up several times a night and the urgency and frequency and sometimes the pain are really getting to me. I don't want to even leave the house. I always feel like I gotta pee.

Sorry I'm whining!

I figure that he wouldn't offer the urolift if it wasn't going to help.

I just don't know what to do! I'm only 57!

Any thoughts?

John  I see you are scared.  I was to when I was told He could not get the cameras in my prostate.  I have a stricture just before the prostate.  So I have it check ever 3 to 4 months.  I was 58.  He started me on a lit of pills to see if he get my prostate to relax.  He said it was the size of a large lemon and closed tight.  I got of the pills fast the first time I had retro.  No way I was going to live like that.  No feeling at all.  That is when he told me about the UROLIFT.  It was only out a year but he told me that it should open me up and there were no side effects.  I had it done 4 weeks later In a week I was great.  He told me to wait a month for sex but I could not wait.  I had to make sure everything was working.  At 10 days I tried and all was a go.  With the other thing that happen 9 month's later.  I got a prostate or bladder infection.  The only meds I was on was Ciprofloxacin 1000mg for a month.  My prostate got smaller.  No one knows why.  But I was happen.  Had it repaired and I'm good.  All works fine on no meds.  I would do it again if the need comes up.  I would never have any procedure that cuts away at the prostate.  I do not want any of the problems or side effects that come with them.  At 62  I am not going to give up on my prostate.  Also I think some of your getting up is your sleep apnea and habit.  Not that you do have a problem going to the bathroom.  But don't worry about the procedure.  It will do it job and you will be fine.  Don't over think it.  I was like you I read everything on the internet and watch all the videos.  I have 4 implant in but never feel them and sleep at night when I go to bed.  It's 2AM  That is were I should me now but watching TV and being on the computer.  Take it easy and relax.  I don't know if you are concerned with your sex life or retro but 9 out of the 10 top procedure cause sexual problem and retro is a given. At our age now we should be able to enjoy life and all it has to offer.  We should not have to give up one for the other...God Bless  Ken          

John   I forgot to tell you I have to have another PSA in 3 month's.  It is a little higher then normal for me.  Last year it was 0.7  this time it was 2.2.  Not going to worry about it.  We will see.  Ken

John, all invasive procedures have potential for side effects and complications, including Urolift, even though they're lower. The success and longevity rate of Urolift is not that great. If you just want to try it out as a little gamble, that would be fine.

However, if money is no subject, I would consider FLA. Though relatively new for BPH, it has good science and many people on this forum had success with it, with zero complications and side effects reported so far. 

Hank

John   That is true all procedures have side effects but UROLIFT.  The only way you can get a side effect from it if the doctor messes up.  Also if the prostate is not the problem.  If you have bladder or kidney problems then it will not work.  FLA is a great procedure if you have the money right now.  It was approved for cancer but not for BPH.  You have to make sure you have a doctor that knows what he is doing.  Like Doctor K.  A few men have had it done by him and they are all doing great.  Urologist is going good for the last 7 years and they are trying to improve it and trying for 10.  I'm at almost 3 years.  If mine is only good for 5 and I was told I would have to have it done again I would  Take care all  Ken  

Wow! You guys are awesome! Thank you for your replies!

My main concern at the moment is the nodule on my prostate. In February my PSA was 4 which the urologist said was high for my age. I had my PSA done today so we'll see what it is. My gut feeling if the PSA is elevated is to get an MRI guided biopsy before doing the urolift. I think that's what the urologist is going to suggest. He had mentioned that possibility at my last visit but changed his mind and offered the urolift.

Money is really tight now. I want to get back to work asap . I had 2 low back surgeries 9 years ago and there are times I can barely move. (Getting that sorted too!).

Trying to get myself healthy enough to live the rest of my life without these annoyances.

I think if my PSA comes back lower than 4 I will do the urolift. I know it's kind of a gamble but maybe it will last long enough and another solution will come about. Don't know what an FLA is but I'll check it out.

The sleep apnea is under control. I used to have severe insomnia, not being able to sleep for 3 to 5 hours sometimes all night but with the CPAP it's more like 45 min until I sleep, which is amazing to me. Peeing still wakes me up though.

Time will tell! I suppose the next couple weeks will be interesting!

Thanks for your input!

Yeah I know!!

I'm gonna check out the FLA.

All surgeries have risks that's why they make you sign so many forms!

I may try the urolift but then again it is depending on so many variables at the moment!

Thank you for your reply!!

Good evening John.  To me it seams like you have everything under control.  I would not worry about the nodule to much your other test came back normal.  I had a MRI with and without contrast.  They found 1 2cm in the lower left lung a 2cm in the lower right lung and something that is 4 X 4 in the upper right lung.  I will be seeing my doctor to see what he wants to do.  Also had 5 nodule cut out of my stomach.  One was black they thought was cancer.  It was normal.  The doctor are trying to find out why I am loosing weight  lost over 100 pounds.  They have been saying cancer for over a year.  Still have not found any.  Just be careful of the doctor what he want to do.  I do not give full control to any doctor.  I do not sign any paper until I read them all.  You should have saw be when I had my heart ablation last November.  I had a list of everything I needed before I signed anything and let them put me to sleep.  Let us know what is going on  Take care  Ken           

PS.  Did you know that a PSA of 4.0 and under is considered normal for any man.......

Holy smokes! You should be the poster child for the living will!! My wife is the same way. What your going through makes my stuff look like a cold!

I know about the 4.0 being the upper limit of normal . But they say that 50 ish guys should be 2.0, 40ish 1.0. the key for me is if it goes up. Since I had a needle biopsy they can't rule out cancer unless they hit the nodule dead on. It makes me laugh that the needle biopsy could be useless! All that uncomfortableness for nothing!

I have a rule I try to live by, do unto others etc and ask the guy who has been through it because they know more than the doctors do about what has happened to them.

I'm trying very hard to make the right decisions about my health because I don't want to become a burden to my kids in my old age. I have alot of living to do yet !!

I'm very thankful for the folks on this forum. I've learned a lot and I appreciate the frankness !

I'll keep you all posted !

Thanks!

Your going through your own drama.  You have to go through a lot to get it right.  I have 3 kids by youngest just turned 32.  Over the last few years my health has been the bits but I still am looking to live a long life.  I have been divorced for 14 years but still like to enjoy myself sometimes have a few lady friends.  I love to travel when I can.  Don't remember if I all ready said this ( Age you know )  But my doctor is looking at my PSA because it is higher then normal for me.  Been 0.4 or 0.7 for years but this time 2.2  I'm not going to worried about it and no one is going to talk me into anything.  I'm not giving up my prostate at this time.  I did have a 13 needle biopsy when I was 47.  It did hurt after and the first time I had a orgasm.  The pain was high,  More blood then anything.  Thank god that went away.  I know I said this.  You have a good wife that sticks by you.  Give her a hug and a kiss and buy her some flowers.  Maybe take her out for dinner this weekend and forget about what is going on.  Take care  Ken     

Thank you for the kind words!

We have 5 children all have been great during my trials! My wife has been awesome through this despite her own issues.

I'll try not to obsess on things!

Dinner sounds like a great plan!

My best to you!

Hi Ken!

My PSA was 3.1 down from 4.0.

I guess to that's good news!

Dinner was fun!

I suppose that I'll try the urolift! Just have to pray and hope for the best!

My best to you!

John

Very happy for you John.  Take care and let me know what is going on.  When do you see the doctor.  When I had mine done I had a catheter for 3 days.  I have a problem peeing on demand.  It's up to your doctor.  One thing get some male pads. Used one the first day after.  I all ways like to be ready for anything  Ken

I don't see the urologist until the procedure on the 4th of December.

But I have to get all the preop testing done. Then my GP to clear me for the surgery.

I'm trying not to over think this so I'm not reading or looking at any more videos!

I'll just enjoy my time and keep contact with my friends!

Thanks for the heads up on the man pads.

Take care! I'm going to try and sleep!

Cheers!

John

John  That is the best think to do.  Try not to over think it.  It will go fine.  I have to do the same thing when I have things done.  I have to get approved by my heart doctor.  Enjoy life.  You have a whole month.  Take your wife to dinner at a different place ever week.  Have a date night and just have some fun.  Good night.  I will say a prayer for you  Ken    

Thank you !

Likewise!

John

Hi Ken!

Wondering how you are.

Gotta be honest! I'm having kittens waiting for the urolift!

Had one question for you. Does the tamsulosin cause breast enlargement in men? What were some of the emasculating side effects you once mentioned?

I looked on line but he info is sketchy.

I think I'm growing boobs!

Wishing you well!

John

John,

According to my uro, there is no risk of growing boobs taking Tamsulosin. I took it for a short while and had the impression that I had a hard time controlling, to the point that sometimes I ran out of time when running to the bathroom. Also, it seemed to me that it favors retrograde ejaculation.

Urolift, if you qualify for it, is an excellent procedure which will leave you with your prostate intact. Best of luck!

Hi Emil!

I've been on tamsulosin for 9 months . My chest seems to be getting bigger!?? Maybe I'm just getting fat! Thank you for the encouragement for pressing on to the urolift!

21 days until the procedure.

Cheers!

John

Emil

Just got a kick in the pants. My insurance company won't pay for the urolift.

Going in to see the urologist tomorrow to discuss options.

John

Did they say way. What type of insurance do you have. You know what he is going to tell you. Turp or laser. Dont do it. Ken

Most insurance companies will not cover newer procedures. They call it experimental because it has not stood the test of time. Doctors malpractice insurance will also not cover for the same reason. Doctors performing newer procedures are aware of this and should so inform their patients during the initial discussion.

John, what are your symptoms? Why do you need a procedure. Are you needing to cath or strain to urinate? What is your PVR? If over 250ml you can be putting a starin on your kidneys, Are you needing to find a bathroom once every hour or more often? I had these symptoms and had to have a procedure. I had two green light lasers which did not go well and a TURP which did. I considered the urolift but my prostate was too large and I had a prominent median lobe protruding into the bladder so I was not a candidate. Many have done well with the urolift, a few have not. It probably depends on the size of the prostate.

to keep this discussion honest, TURP worked perfectly for me and for many thousands of others.  Like all medical procedures, it has evolved and improved over the years.  Best advice I received was to educate myself on all the options and choose the one most appropriate for me

Hi guys!

Yeah I know what he'll say !

I have Gateway insurance. They don't pay for it because it's too new a treatment.

My symptoms are if I drink anything I have to urinate every 20 min. Residual volume is 250 to 300 ml. Don't self Cath. I'm up 4 to 5 times a night. When I'm on the tamsulosin and 10 to 12 when not. Many times I barely make the bathroom.

To look at the other side.  There are many men on here that have said that having a turp was the werst discision they everr made. Ken

Residual volume is 250 to 300 ml. Is it with or without tamsulosin ? Up 4 to 5 times a night with tamsulosin. Did you ask for higher dosage ? Hank

Hi John,

Have you considered self cathing (CIC) while you make up your mind? Sounds like you might be a good candidate. It will empty your bladder completely, so probably no more urinating "every 20 minutes" and fewer night time interruptions. It will also protect your bladder and kidneys as well as any surgery. But if you do decide to have something done, consider urodynamic testing first to help determine if you're a good candidate. With some, LUTS is more related to the bladder than the prostate, and in these cases, surgery may not do the trick. Urodynamics will help determine where the problem lies. 

Jim

Hi John, 

You are pretty much where I was back in 2012. You need to do something. Everyone has different experiences for sure but from my experience the GL laser was not a good option but the TURP was. Ihad the TURP in June 2015 and I just drove to Costco about a half an hour away, spent a half hour there, drove back and haven't gone to the bathroom since I left the house more than two hours ago. On the other hand I still get up 3 times a night. I use a couple of 1 liter plastic urinals in a plastic waste basket on the floor ny my nightstand. I use them in the dark sitting on the edge of my bed and am back to sleep in a minute or so. Many have found that a procedure will cure the PVR, frequency and urgency, but our bladders still need to empty out several times at night.

4 or 5 times a night with the tamsulosin. I had urodynamic testing. My bladder is still ok. I was sent for pelvic floor exercises and biofeedback and it helped a little but not all that great. Wasn't given the option by the doc to self Cath. I feel like I'm always on the verge of dehydration because it's such a pain to drink and then spend the rest of my time urinating! If I want to travel in the car I don't drink for 12 or so hours so I don't aggravate the family finding a bathroom for dad. Not hydrating can't be good for you. I also hate the feeling of always having to pee! I'm touched by the concern you all have for me! Thank you!

John

@John: Wasn't given the option by the doc to self Cath

-------------------

Unfortunately, it often isn't given as an option for various reasons, most of them which are not medical. If self cathing has any appeal, then it's sometimes incumbent on the patient to seek it out himself, either from their current or another urologist. The great thing about CIC is that it's easy to learn and try, with results that are immediate. And unlike a surgery or procedure, no possibility of long term side effects. It's unfortunate that docs don't encourage their patients to try this option prior to surgery in the same way they encourage them to try Tamsulosin or Avodart. Maybe the cath reps are not as persusaive!

Jim

 

John,

I never restricted my liquids for two reasons. One I didn't want to get dehydrated. Two I can't stand being thirsty. A year after I retired I got a job with a long commute (about an hour and 15 minutes each way). I pulled over and used a urinal then emptied it by opening the door wide enough to pour it out. Same thing on longer trips. When I had people in the car I would put a jacket over my lap and ask them not to look. Since my TURP I haven't had any of those issues, knock on wood.

Hey all!

I'm a little afraid of the CIC .

Isn't there a risk of UTIs?

I did the urinal thing when I had a long commute to work.

We'll see what happens tomorrow.

Thanks!

John

Nothing is perfect but the risk of UTIs from CIC can be minimized by taking prophylactic antibiotics for a day or two when you first start. After that, most people adjust very quickly and UTIs should not be a big problem, although they might occur. Personally, after the initial period, I've averaged probably one UTI a year from CIC, which is less than I had before I started with CIC. Some have more, some don't have any, but I wouldn't let that get in the way of trying it out and seeing how it works. I mean if you compare the potential of UTIs from CIC to the potential side effects of a surgery or procedure, CIC wins on any scorecard.

Unfortunately, many are afraid of CIC, for reasons other than medical or even rational.  I was one of those in the beginning, and all I can say is that once you get the hang of it, CIC can become as easy and routine and brushing your teeth.

Jim 

Hi Jim!

I had to be cathederized for my urodynamic testing. I hated it! Don't know if I could do that to myself!!

I do get the concept but I don't know!!

Thanks !

John

John,

I understand your reservations but consider that learning how to self cath will be far less traumatic than recovering from surgeries or procedures such as PAE, Rezum, TURP, FLA, etc, where you might need to wear a Foley for a period of time in addition to the healing process. So, if you're planning on going through with all that a surgery or procedure involves, why not try something much less invasive first?

I do understand you didnt' like being catherized in the past, but once the body adjusts it really isn't a big deal. And again, you may have to go through it anyway if you go straight to a surgery. 

Jim

 

Jim

It certainly is an option!

I'm pretty befuddled at the moment.

I've got to do something because my life is being ruled by my bladder!

I really do appreciate your suggestions with the CIC.

I know that with any surgery you can't go back once it's done!

Lots to think about!

Thanks!

John

Well everythimng is done.  After 5 painfull catheter insersion. Had my surgery. He found nothing wrong.  Bladder is fine.  Prostage is fine clips are holding it apart. No bladder stone. It was the bladder clip. Near the bladfer neck. He had no problem putting in a catheter. Do have some irritatesion from them putting the other 5 catheter in. I will be taking out the catheter on Friday. And i will see if i can pee on my own. If not we will go from there. Thank you all for you well wishes. Ken

Sorry about the spelling doing on my phone. Ken

Hi Ken,

Glad things are over, at least for now. Did they find the reason why you first weren't producing urine and then not able to void? Was it a stone?

I'm almost getting a UTI just reading what you've been going through, so definitely be on the lookout and ask for antibiotics at the first sign.

Jim

John, that's right. With a surgery you can't go back, but with CIC you can, and easily. You just stop cathing! If you decide to try it, just let me know and I'll walk you through what to get and how to do it, etc. Really not complicated but the right tools make it even easier. 

Jim

Yes for now. Thank god. He does not know why they had so much trouble getting it in. Im sorry but i know why you hit.my prostate. Itt hurt bad. No stone. It was one of the clips from the urolift. It is near the bladder neck. He also said with everything in place and looking good he does not know why i stopped peeing. Having the catheter out friday. Having blaffer spasms. They hurt. Have a towel under me to catch the stuff that come out around the catheter. I wish i could have it out now. Very uncomfortable.  Take care. Ken

Johnn. Listen to jim. He know what he is talking about. He can help you.  And that is right. When they start cutting out your prostate and it does not work. You cant have it put back let jim help you. Ken

Ken,

Maybe the catheter was hitting the clip? Just an idea, but if you need to be cathed again, maybe ask if it could be ultrasound guided so they can see what's actually going on.

I guess the mystery still is why weren't your kidneys producing urine at first, and then why were you retaining? If it wasn't a stone, what was it? Hopefully, it will be one of those mysteries that resolves itself. I just wish you didn't have so much difficulty with CIC because it would be a handy tool for you to have in case something like this happens again. 

Please keep us posted, we're all rooting for you.

Jim

Hey Ken!

Sorry you are having some issues!

I hope they get better!

You are in my thoughts and prayers!

John

Its funny how things change so fast. I was fine one day and nexts day can't pee. The doctor putnin a catheter while i was out no problem.   We will see if i can pee fri when they take it out. Ken

Thank you john 

Geez!

My best to you!!

John

Jim

Something I didn't think about with the CIC. My wife is strongly against catheters. She was in the hospital and they catheterized her and she had a royal fit!!

If I start cathederizing she won't come near me with a ten foot pole!

She's afraid of urinary tract infections. 16 years ago she had a UTI and the cocktail of antibiotics they perscribed her caused a bad reaction . She lost her speech, muscle coordination, and depth perception as well as several other milder problems. It took a long time for her to get all of that back.

I know she will not be very agreeable if I start cathederizing.

I know that some would think that if CIC would be better for me she should be supportive.

I just don't want to put her through having to worry about getting another UTI. Even though I know the chances are slim that she would get one from me should I start CIC.

I just can't see having her thinking about getting a UTI again.

Catheters are a very hot subject with her!!

Thanks!

John

Hi John,

You can tell your wife that UTIs aren't contagious!

Jim

Hey Jim!

I know that but that's not what she believes!

She absolutely hates doctors!

She doesn't trust them either!

Last time she was hospitalized she almost died! Seriously!

Time for me to hit the rack!

Cheers !

John

Hey Ken!

How are you doing?

I've been thinking about you!

Cheers!

John

Good evening John.  Doing much better got off the flomax.  Been going to the bathroom ok.  I still have pain sometimes on the right side but all is doing good.  How are you doing..Thank you Ken..  I hope I stay out of the hospital  Don't want to go through that again  

Hey Ken!

Good for you!

Hang in there!

Have to go to bed!

Goodnight!

John

No problem  I just got home so I will be up for a while  Have a good sleep  Ken

Good evening John  So how are you doing today any better.  Did you have a good night.  I hope Take care  Ken

Hey Ken!

Battling a bad cold!

Otherwise okay!

Really tired!

My best to you !

John

Hey John sorry about the cold.  Hope your taking something for it.  Spent more of the sending e-mails on the Holep Procedure.  I am trying to find out if the procedure can be done on one side only.  Why should you have both done if you don't need it.  There are still a lot of men 45 and up that still want to save there ejaculation.  It's our bodys and we should be able to have any procedure done the way we want.  I read a article from the Mayo that 3 out of 10 men will have retro after the Holep procedure.  I try to think out of the box.  It keep my doctor on his toes..  Hope you feel better soon  Ken    

Sorry that was wrong.  It's 7 out of 10 will have retro after the Holep  Ken

Hey Ken.

After much deliberation I've decided to go with a TURP . I believe it's the button type.

With all the trouble I've had lately I really don't care about the retro.

I may have a choice of the laser I meet with the doc end of the week. I'm hoping for the best.

John

If you are talking about a Plasma Button Turp.  It is much better then the regular one.    They have more control over the button where they take off the tissue.  And there have been a lot of men that have had it and they don't get retro.  I know at our age.  I'm 62 but I'm not ready to give up anything if I don't have to. God gave it to us for a reason but I don't think kids was the only one.  I have never been a fan of the TURP surgery because it is barbaric.  The plasma turp give you the same options  with a better out come.  There less bleeding to.  Just be careful want you pick and if you can deal with the side effect all of them not just retro.  And don't let your symptoms pick what procedure you have  Ken      

Hey Ken !

Wrestled with this for weeks. The decision wasn't easy but I need to get my life back. I have the time now to able to recover so it's a good time to do it.

Barberic? I don't know . I have 4 screws and rods in my lower back . That was barberic!!

I know that once the tissue is gone it's gone but the gains I get outweigh the loss of tissue.

We'll see how things go at the end of the week.

Best to ya!

John

John;

Most people who have a TURP (and need it) do well and are very glad they had it done.

All the best.

Hi!

I'm trying to be positive.

The only hesitancy I have is that the urologist thought I had dysfunctional voiding. I went through the pelvic floor training and timed voiding but it was little help.

I had a cystoscopy and all the urodynamic testing. I came up as obstructed.

Can the urologist tell when they do the TURP if the tissue has changed and maybe it's not the prostate itself not decide to do the procedure?

Wondering??

Thanks!

John

But isn't the Plasma Button Turp better. And you have less side effects I watched a videos on a regular turp procedure and it is a shame what you do to a man just to have him pee better. It is barbaric.  I could not watch the whole thing   Some men do well but there are others that after a year they still have to deal with the after effects of surgery. Ken   

Hi John,

You want to know BEFORE the procedure if the prostate is the primary issue!

Do you know what your post void residual (PVR) is?

That's the amount of urine left in your bladder after you void. Sounds like your doctor thought you might have overactive bladder (OAB) with the Kegels and timed voiding. I'd get that all straightened out and get a firm diagnosis before having a TURP or any other procedure. And speaking of other procedures, there are a lot more to choose from these days than TURP.

Jim

 

The vast majority of men who have this procedure performed (and have documented BPH) are happy afterwards.

I like using Plasma Button technology, but other surgeons are more comfortable with other modalities; I don't believe any method has proven superior.

John  Please Please make sure it is not your bladder.  Because once you have the surgery they can't put it back.  Do your self a favor watch the TURP video and see what there going to do to your body Good Luck.  Remember most doctors are like car sale men they can talk you into anything..Ken 

Yes please find out what is wrong first.  A urologist will do many test but if he can't find what is wrong.  They assume it's your prostate and cut away they will but after if you have the same problem it's to late for your prostate..Gold help you make the right decision Ken

Hi Ken, You will still get the same incidence of retro from a button turp as a regular turp. To quote my ex urologist when I asked him the chances of getting retro from a button turp. He said, "100% If I do it right". So there's that. 

jim

Hey Jim!

Residual volume 175 to 300 ml.

I think the doc thought I had dysfunctional voiding because of the way my detrussor muscle clamped down when I got my cystoscopy. They did it while I was awake and with no numbing at all. That really hurt!

Thank you for that.  But how many are happy with the side effects of a regular Turp.  We have had many man on here that are happy with being able to pee but they were not ready for the side effect any of them.  Many have losted not only there ejaculation, or all together there sex life or HAVING TO WEAR A DIAPER.  But were happy life go on maybe   Ken

Aaaaaaaaagggggghhhhhhh!

I think it all depends on the surgeon We have had men on here that have had the button turp and they did not end up with retro.  They can stay away from all the good stuff if he care enough about is patients and not just adding another number to his list.  Ken

Hi John,

That residual supports the "obstructive" diagnosis from your urodynamics. How much are your natural voids averaging? If your natural voids plus your residual are too much over 400ml, then your bladder is probably distended. A bladder/kidney ultrasound study will also help here in terms of both bladder architecture as well as any potential kidney issues such as hydronephrosis (water in the kidney). 

If it turns out your bladder is distended, which is likely, then you might consider some bladder rehab via self cathing first, instead of going straight to a surgery. Because if your bladder does get better, it sometimes can significantly improve your whole voiding process even with an obstruction present. 

Jim

IT'S NOT A PRETTY SITE WHEN THEY START TARING AWAY at the prostate   KEN

Hi Ken,

You're correct the number is not "100%" but I was just quoting my uro to make the point that there is a high incidence of retro with all forms of TURP. If you are lucky enough to find a surgeon both skilled and motivated enough to put in the extra time to better the odds, that's great, but it would not be your average doc. Better probably then to look at other procedures if retro is a major issue. 

Jim

Hey Jim!

My natural voids are between 175 and 225 ml. However my bladder was normal according to the urodynamics.

John

Yes that is true.  They do not look at retro has a problem.  You may as well say lets shoot them or put us out to pasture But that is why we need to find our self the best doctors we can for us.  If he does not care enough to listen and speak of our concerns you need to turn around and go out the door....Ken

Sounds right based on your numbers. I would still suggest a trial of self cathing before surgery,  but I understand it's a "no no" with the wife! If rero isnt an issue, then TURP will certainly get rid of the obstruction. And then there are the newer, less invasive procedures with varying degrees of success.

Jim

Hey Ken !

I have watched the procedures on YouTube. Eh not that bad. Watch a laminectomy and fusion of the lumbar spine, that's some good fun!

I appreciate all the input!

I had prostatitis back in 1996. Peed my pants on the New Jersey turnpike! It was hard to start peeing, low void volume, urgency some pubic pain. I feel almost exactly like that now except I don't have prostatitis.

The symptoms have gotten worse over the last year, significantly. I would think that detrussor muscle hypertonicity would be either on or off?? Or am I missing something?

John

John it seams like you been through alot.  Your a better man then I .  I could not watch the whole procedure.  I think it's wrong to do that to another man.  I think sometimes doctor forget they are also men and what they are doing to other men. I like Heart surgery  That videos is great  I sent you a PM  Just please think before you say say and check out other procedure that will do the same thing  Ken

Ken,

When I had my back surgeries I watched some videos beforehand. Wow a hammer and chisel! Awesome! Drill? Great!

Then I tried to stand up from my chair! Eh, I'll be asleep for it!

John

Yes I know.  I had a heart ablation done last year 9 hours.  I watched the video on that.  It a marvel what they can do.  But to destroy the prostate to hopefully pee better.  There are do many other procedure that will do the same.  And like you say your insurance will cover it.  That is not a reason to pick any procedure even if you are having a problem..  I wish you well and I hope you know what your doing. Ken 

John, after a successful turp your PVR should be about 30 - 50ml. So if you add your PVR less 50 ml to your normal void, you should get about 300 to 500 ml voids after the TURP. Which is fine. 

Having had 2 Greenlight lasers and a TURP I think I have some real experience here. 

One misconception I've seen here is the idea that the TURP is any more barbaric than a laser. That's not so. Would you rather have your tissue sliced (TURP) or vaporized with a blow torch (laser)? If you look at the youtubes of the aftermath of a laser it's not pretty, it's a torched wasteland.

More importnty, a TURP preserves tissue which gets sent to pathology to see if there is any Cancer. Most lasers vaporize the tissue so there is nothing to sample. Needle biopsies only sample very small random sections of the prostate. The reviewing of tissue removed in a TURP is a much bigger sample. 

A second fallacy I keep hearing is when they remove the prostate tissue it's gone. If only that were true. The fact is that it's gone the way your hair is gone when it's cut. It grows back. Hopefully not too quickly, but most men regrow the prostate and have new issues in 5 to 7 years or quicker. The prostatic urethra reforms and the prostate starts growing back as soon as it is healed, which is generally a few weeks or a couple of months at most. My prostate was  bit over 300g. when I  had my second GL. It regrew back over 300g. when I had my TURP 30 months ago, which removed over 100g., 18 months later it was up to 235g, despite me taking dutasteride daily for 12 months. However I still have a good stream and have no problem voiding and my PVR was just 34ml when measured last year. It's not the size of the prostate but the position of the obstruction that is important. The only thing that removes the prostate permanently is a radical protectomy.

Another issue talked about is retro ejaculation. My two GL's spared tissue so I didn't get retro. My TURP did not. I was so worried about it before and after my TURP, but when I had my first orgasm after the TURP I had forgotten about it and never noticed it. The sensation of the orgasm is the prostate pumping about a teaspoon of semen during the process of ejaculation. With retro it is the same but the semen travels up into the bladder instead of down and out. The ejaculation is the same, the semen is rerouted.

Having had several prostate procedures in just the past 5 years, I can say for me the GL lasers were not a good solution for decreasing the PVR and being able to void properly. The TURP was. But none of the procedures eliminated getting up at night. The way it was explained to me was that years of bph (probably 20 years) caused my bladder to get muscular to push out the urine and decreased my bladder capacity permanently. I pee when I go to sleep and pee when I wake up and get up every 2 hours or so, so 3 to 4 times a night.

 

Hi Bob, in comparing TURP vs Laser, is it correct to say that there is more bleeding, longer healing time, and more dead tissues in TURP ? Hank

Hi Hank,

I found the opposite to be true. Recovery from the laser (bleeding, pain while urinating, urgency and frequency) was 8 to 9 weeks with the GL laser and just 6 weeks with the TURP. The dead tissue was minimal with all the procedures for me, and nothing obstructive, The big issue for me was a few months after the lasers my voiding got weird and incomplete and my PVR was up between 125ml and 200ml. After the TURP I had regular voids and a PVR of just 34 ml. at the 6month and 18month check ups. I'm due for another one. After my TURP I thought it would be a good idea to have my PVR and prostate size checked once a year with a sonogram.

Bob  I am happy for you finely after 3 procedure.  But I think you were one of the lucky guys that the turp did not take away the feeling of your orgasm.  There are men that hate it after because it is not the same so they decide not to have sex again.  All men are different and we all heal in different way.  It's a shame that we can't tell before hand.  It would make life easier   Take care  Ken  

Thanks for sharing your experience Bob.  I've been reading these posts here for several months now and I think that's the first time anyone said their bladder capacity was decreased.  Very interesting.

Ken, very true. Life is a crapshoot for sure. I've always had a strong libido. I don't think anything has stopped it. I'm still a horny teenager although Im 71. I have afib and luekemia. I've had to give up liquor and caffeine and have lost 2/3 of my strength energy and stamina. But when it comes to orgasms a line from a Woody Allen move comes to mind. "Every orgasm I ever had was spot on."

Regards. Bob

Very happy for you.  Keep going as long as you can.  I wish there was a lot more me that would love that.  I'm 62 and I had a UROLIFT done almost 3 years ago.  My orgasms are intense to but will not take a chance on losing it.  Enjoy life  Ken

Hi Bob!

Had my TURP on December 4th. Plasmakinetic resection with vaporization. The doc said it was a wire device not the button type. My voids are very frequent an about 100 to 120 ml today compared to 150 to 175 ml on the day after the procedure. When I urinate the flow is really fast but stops abruptly with great pain that I can't really locate.

I've been walking around the house , climbing stairs, but not lifting anything. Sitting mostly in my lazyboy. Should I be off my feet and butt resting in bed to take the pressure off my perineum?

Am I doing too much? There is quite a lot of pink and sometimes a cranberry tinge to my urine. When I was lying down this afternoon I had a few voids that were yellow but as soon as I sat in my chair they became bloody again.

The pain seems to be coming from inside the base of my scrotum area.

This afternoon I was urinating every 12 to 15 minutes for about 2 hours and I cut down on my drinking . Now it's about every 30 to 45 minutes.

It's only been two days and l was home on the same day of the surgery with the catheder out the next morning.

Am I expecting too much?

Thanks!

John

Hi John,

After my procedures I tried to drink about 3-1/2 liters of water a day. I measured input and output on my first GL but didn't bother with the second one or the TURP. I think it's important to keep flushing your prostate to get all the debris out. I experienced bleeding from 6 to 9 weeks on my three procedures (2 GL lasers and 1 turp). I experienced eye popping pain at the end of each urination for about 6 weeks. My urgency allowed me about 5 seconds to get to the toilet at first, and my frequency and urgency slowly got back to normal in 6 to 8 weeks. I wouldn't attempt any exercise. If you are getting up to go to the toilet frequently, getting up for meals, washing up, etc. that is exercise. I used pain pills for a couple of days but stopped taking them. For the pain at the end of urination. I hyperventilated before starting urination and kept it going until the pain stopped. It was usually only a few seconds at the end of each urination, but felt like being stabbed with a spike. Everyone takes a different amount of time to heal but I read that your procedure, known as the PKRP generally heals faster than the TURP. It might depend on how much prostate gets removed and how large the prostate is to begin with. Take it slow and prepare for an extended recovery (6 to 8 weeks). If it goes faster you will be pleasantly surprised. 

Hi Bob!

Thank you for the quick reply!

Yup , the pain is eye popping!!

I just wondered if it was "normal".

So , do you just stop urinating when it hits because it makes me feel like I want to keep "pushing" to urinate.

I'll try hyperventilating!

Thank you again!

John

Joh, you are very welcome. I never felt the need to stop or push either. Just let it come out and accepted the pain would be there at the end but wouldn't last long. Hyperventilating helped take my mind off it. 

Bob, I feel like I want to push when he pain hits. Should I just try not to push or go with pushing along with the pain? It feels like trying to push out a banana out of my pee pee hole! (Who needs medical terminology?).

Cheers!

John

Hi John. I wonder if you have some debris there blocking the path? This didn't happen to me but others have spoken of it. My gut feeling is do what comes naturally.

Hey Bob!

Never thought of that!

I'll see what happens today and if it keeps up until tomorrow I'll call the doc.

Thank you again!

John

Hi Bob!

Seem to have turned a corner. Lots less frequency way more flow and less pain. The bleeding is intermittent and seems to happen when the pain following urination happens.

Feeling way better. I think I'll take another day or two and rest in bed like I did today.

Take care!

John

Hi John,

That sounds really good. Take it easy.

Bob