Turp operation or laser ?or leave alone?

Hey Boys!

So many different procedures, so many different outcomes!

It's like buying a lottery ticket . You never know what you will get but you still lost your dollar!

This is a tough decision!

John

I don't know if I trust my doctor or not.  Only saw him for about 5 minutes and he gave me a GL dvd and pamphlet.  Then he scheduled me for pre-op in 2 weeks.   He said "I'm glad you came in"... which could mean "I'm glad you came in because you need help" (which is what I took him to mean) or it could mean "now I can afford a new car".  I've been in there twice now with an appointment but have only seen his female P.A. 

I don't know about you but that seams like it is to quick.  I would wait and see another doctor.  Do you do any other test.  Having 5 minutes of a doctor time to make that choice is not right.  When he talk to you in that 5 minutes did he tell you anything...  I think a second oponion is needed  Ken

Yes, it seemed that way to me.  Thats why I waited.  CIC seems to be working well for me; thank goodness there was advocacy for long-term use of this method because I still have all my options open. I did schedule a cystoscopy for after the 1st of the year.  I just wonder what exactly the obstruction is even though its probably your typical BPH.  The onlly test I've had is the gloved finger up the anus twice and both doctors agreed yes, my prostate is swollen.  I got prostatitis probably due to urinary retention a few months ago but that as well as some other conditions have cleared up now that I've been catheterizing.

 

With them doing the finger test and you having prostatitis that could be why your prostate is swollen.  I get that to but not running to have it cut out.  I will just do CIC for now as long as it works.  They them have a nice day.  Take care  Ken

Your symptons are not unusual for bph/luts. Yes, some of us have urgency, but some have almost no sensation or signal to void because our bladders are stretched/flaccid. I was in your position four years ago and decided to do nothing (other than self cathing) because I didn't like the risk/side effect profile of the surgeries being offered. That doesn't mean people aren't happy with TURP, but do your research so you know what you're getting into. As to self cathing, the key is to keep total bladder volumes under 400ml. That would the the sum of your catherized void plus any natural void preceding it. If four times a day does that fine. If not, I would increase frequency. No guarantee, but if you follow that script and decompress your bladder, it's possible that more sensation will return to your bladder and it will start acting and signaling you more normally. It did for me.

Jim

Jim.  Are you sure it's your prostate that is causing you the problem.  To me it sounds like it's your bladder.  Please make sure before you have something done that is not going to fix the problem and cause you more problems to deal with.  Has long as your peeing and doing the CIC  you should be fine.  Don't cause yourself more headaches.. Please get more information Ken

Ken makes a good point. Assuming you haven't, before you consider any surgery, best to have urodynamic testing done. It will help differentiate between prostate, nerve and bladder issues and therefore help point you toward appropriate treatments.

Sorry, but at your age, I would avoid surgeries unless it's absolutely necessary, especially TURP, which can have a brutal post op recovery. Instead of advodart, you may want to consider an alpha blocker to help you with CIC. Hank

What we are trying to tell you is make sure you fine out what is causing the problem before you make more.  Don't let your doctor talk you into anything.  Did he tell you that it will fix the problem.  Do you know a doctor can tell you what he thinks may fix the problem but in realty he does not know if it will.  But after he cuts it out it's to late.  Good luck..Ken  Here is something my Urologist took me.  He said that the TURP is a last resort procedure.  I don't think that your there yet.  Please get as much information you can  God bless  Ken   

I had two Green Light lasers (not that successful) and a Turp that did work to get me a good flow and a low PVR. Before my first GL I had to go every 20 minutes and was getting very little urine. That is because the canal from my bladder to my urethra (the prostatic urethra) was being piched shut by my prostate. My urologist took pictures with a cystoscope and showed me how my prostateic urethra was pinched together like butt cheeks. The first time I went into full retention I was cathed at the ER and had 1400mls. The fact you can go on your own when you fill up sounds like a bladder issue (a diverticulitis - a pouch in the bladder) or a bladder that has lost elasticity and the ability to feel when it is full and push out the urine. My cousin had this condition, was cathing for years, got a turp that worked for a couple of years, then had to start cathing again and has been ever since. I would get a second opinion.

Hi Michael,

Have you looked into self catherization (CIC)? CIC is an easy to do and learn technique that empties your bladder completely and quickly, so you be able to go to plays, movies and football games, just like before you started having issues. A lot of us here do it and we will be happy to help you get started.

Jim

Very good philosophy ! Yes, life is a gamble. At least you aren't worse off than before TURP. Hope you'll find a solution for your problem. Hank

There are some theories that prostate issues can be caused by low-grade chronic infections.  They can be non-bacterial as well as bacterial.  From what I've studied, I do think there is some validity to this for some men. 

Michael  I am sorry for what you are going through.  But I hope I say this right, Did your doctor check you for a infection before the surgery.  You had some type of prostate infection.  If you do any research on having any procedure the first thing is that you should not have any surgery done if you have a infection.  Because you were inflamed and your body was not right.  Your doctor should have stop and sent you home to heal from the infection and they do the surgery when it calmed down.  But what done is done.  Please listen to Jim  CIC will get you out and about.  You can go many places and you will not be stuck at home.  I hope thing work out for you.  Take care  Ken

Hi Michael. I'm 71. I can sympathize because I've been there. I have one of those prostates that grows like a weed according to my urologist. He gave me a GL laser in 2012, a second one at the end of 2013 and a TURP in 2015. At the end of all of that my prostate was larger than it had been before my first GL, but my urination symptoms and PVR have been good so far. Apparently it's not the size of the prostate but the size and position of the obstruction that causes urinary problems. 6 months after my third surgery, the TURP, my prostate was 195g,, but I had no symptoms and my PVR (post void residual) was just 32 ml. When I started the odyssey in 2011 my prostate was measured at 128G. and my PVR was 400ml, and I was needing a bathroom every half hour to 40 minutes around the clock. 6 months after my turp in 2015, I decided I didn't want a prostate operation every year so I asked my urologist to put me on dutasteride (0.6mg a day). He was reluctant, citing possible side efect of growing breasts, etc., and wanted to prescribe a less effective drug, finasteride, but I was insistent on trying the dutasteride. I've been taking dutasteride for 2-1/2 years and have had no side effects. Presently my stream is decent and I go several hours without a bathroom visit. I don't have any urgency. At night I usually go 2 or 3  times during 8 hours of sleep, in a couple of 1 liter plastic bedside urinals I keep in a basket by my bed. Sitting at the edge of my bed in the dark to relieve myself, I can get right back to sleep.  Can't help but wonder what would have happened if I had just started taking dutasteride around 2010. Maybe I would have avoided those three surgeries?

When my urologist did my first GL laser he said he encountered numerous pus pockets indicating chronic non bacterial prostatitis for years. Interesting but they never showed up on any tests and there was no cure for it anyway even if I knew I had it.