TURP relapse after a year?

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i had a TURP a year ago and had nominal improvement for the first few months in terms of flow and frequency, although i was still needing to pee at least every 1.5-2 hours and still getting up at night. But after a year since surgery i have reverted back to just how i was before my TURP. I need to pee as often as every 20 minutes in the morning after drinking coffee and about every hour any other time and only pee a small amount like 20-30 ml most of the time. The stream is again a dribble most times . I am so frustrated and cant find anything online that discusses this condition or why a TURP may have relapsed Have others experienced such a quick relapse? What could be causing this? I have done another cystoscopy that found no blockage and no apparent problem where the bladder neck was routed out. My urologist cant offer any reason for this Does anyone have any on what the problem may be and what to do?

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  • Posted

    Did your urologist do a complete urodynamics study BEFORE offering TURP? If not, fire him/her. Often times, it's not a BPH issue. Could be Neurogenic bladder, destusor muscle issues, Urethral sphincter, OAB, etc, etc.

    Please tell me you had urodynamics done before your uro offered surgery, because it's getting to the point here of just too many uro's simply out to make a buck, and not caring about actually helping patients truly.

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    • Posted

      No, there was no new urodynamics test done before the TURP. But I tried to do two such tests in prior years that didnt work The first one led to a vasavagal reaction when they overfilled my bladder causing me to lose consciousness, fall, and hit my head and get a concussion. When i tried again a few years later I could not urinate even after my bladder was filled (and who can when you've got a team of people watching you standing there trying to pee!) i have been seeing urologists for 30 years now (I'm 62 now) and have had repeated problems and surgeries for stones that grew in my bladder due to urine retention, poor flow, and frequency of urination. i don't know what else to do, everything i have tried has failed, and now the most radical step, a TURP, has failed too . any ideas would be welcomed!

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    • Posted

      surgery is not always 100% successful. there is always complications. ur situation may not be as complicated as u think. my holep surgeon told me that after holep there is a 5% chance of scar formation. the scar will block the urine flow giving typical BPH symptoms. another operation will be needed to remove the scar. 5% rate is pretty high considering incontinence is only 2% after holep. when the scar is in the prostatic urethra it is called urethral stricture and if the scar is formed at the bladder neck it is called senosis(?).

      if u read clinical trial reports of turp, in some trials there is a few percent of patients which need reoperation. u could be the unlucky one.

      the only way i know if ur old symptoms has come back is due to scar formation is to do a cystoscopy, which uses a scope to examine the prostate and bladder thru the penis.

      regardless what the cause is, it seems that TRUS , urodynamics and cystoscopy together shall be able to diagnose the real cause.

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    • Posted

      Certainly. I'm not a doctor, but sounds to me you have weakened bladder muscles/ Neurogenic bladder. Anyone check for Bladder Diverticulum?

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    • Posted

      yes, i had another cystoscopy done on my birthday (what a present) 9 months after the TURP because i too thought there may e a stricture or scar tissue impeding the flow but everything looked normal so that wasnt the reason

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    • Posted

      and after that cystoscopy is when i gave up and have just lived with it again, much as i hate doing so my urologist wanted me to keep a record of what food i ate compared to how often i pee and at what volumes. But i already know that it isnt some specific food causing this since i eat a varied diet, i do know that coffee seems to make me pee more often (not unusual), and i know that my frequency has reverted back to what it was with lesser volume and flow than i enjoyed for a few months after the TURP. It's like i went theu all that for only a slight, temporary improvement that has totally disappeared by now

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    • Posted

      turp only cleaned out the adenoma or overgrown tissues. if cystoscopy showed that ur urethra is wide opened, then by process of elimination, ur bladder could be the problem.

      the earlier suggestion that u do a urodynamic test is a good suggestion. it can tell u the pressure ur bladder is applying, the max flow rate, etc. if the pressure is normal and ur urethra is wide opened, by law of physics , u should have a very strong flow unless one or both of ur sphincters is not fully opened. not sure if u agree.

      i would switch urologist as ur current uro can not find out what the problem is. it seems to be beyond him.

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    • Posted

      People in the room during the urodynamic test? I had one recently and was left alone until I finished. I couldn't pee with people watching either.

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  • Posted

    I underwent TURP for BHP and situation improved dramatically except for one side effec. Now, 02 years after surgery I am doing very well. So, assuming that your only problem was BHP one can come to a conclusion that it was an unsuccessful TURP operation. However, you should also check whether you have other issues such as bladder problems by further tests.

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  • Posted

    I was experiencing the same symptoms that you describe and they performed a urodynamics test 15 months ago. I was diagnosed with an enlarged and neurogenic bladder. I was retaining 1.5L of urine. I have been performing CIC since then to empty my bladder. I haven't a natural void since I started CIC. My uro is not pushing for surgery, as he is not convinced that it would help my problem. I'm satisfied doing CIC, as I am on a regular voiding schedule and there is no leakage. In addition, I can sleep through the night.

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    • Posted

      There's a user on here, forget his exact user name - Jim-something.. Similar situation to you and in time, he brought his bladder back by CIC to the point he basically naturally voids on his own. Try to do a search for his method, as it's an exact type of method he used.

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  • Posted

    Thanks everyone for the helpful feedback. Seems that a urodynamics test is needed to really determine the issue.....but, I've had no luck in being able to do such a test successfully. I will go see my urologist again to see what the options are. I'll ask about bladder diverticulum, destusor muscle issues, neurogenic bladder, etc but I expect the answer will be to try another urodynamics test. BTW, does anyone know, is urodynamics the same as a cystometrogram test??

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