TURP verses Everything Else

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I have read for several years the Patient blog looking for the correct way to handle my enlarged prostate issues. I have learned a lot and am grateful to those that went before me and posted their experiences. The idea of a TURP scared the hell out of me, especially after reading some experiences, all negative. Instead, after an examination by my Urologist, I decided on a PAE. He told me that I was not a good candidate for a Urolift due to an enlarged median lobe. He offered a procedure called a Greenlight Laser. I went for the PAE. The procedure for the PAE was effortless and for about 6 months after the procedure it seemed like I had made the right choice. It was not to be. I switched Urologist for a number of reasons and found one that I could talk to and discuss my feelings and how I may have made a mistake with the PAE. He was very accommodating and a good listener. He started off with a cystoscopy, my third one and uncomfortable. His opinion was a TURP was the only way to go. Not what I wanted to hear, yet, I decided just to get it done because of all the problems, UTI on a continuous basis. After the procedure, I could urinate like I was 20. A feeling I had not had in some 30 years. He also told me my median lobe was the primary culprit of my problems as the prostate was not as enlarged as he thought it would be and was rated at 43 grams, which is rather small compared to most people that have posted on here. The median lobe was really enlarged and elongated (something unusual). I was drawing close to having a catheter as my only relief. The TURP turned out to be entirely painless and not one instance of the discomfort I had read so many times about. The catheter was left in me over the weekend (3 days) and removed first thing Monday morning. I was put on a new drug called Uribel for pain and as a antibiotic. It turns your urine a beautiful color of blue. My TURP healed with no issues. Urinated blood one time after four weeks and it never repeated itself. I am off all prostate medications. My urination has slowed a little and not the firehose effect I initially had after the TURP, but so much better. My only issue is a flair up of inflamation of the prostate every once in awhile. Working on that issue. After all the aggravation and making decisions, do the TURP and get it done correctly. There is retrograde ejaculation and for those that want to father children that may be a show stopper. For me it was not. Also, I was put on Finasteride 5mg (generic for Proscar) to prevent my prostate from regrowing and eliminating another TURP years from now. Warning: Proscar can cause an aggressive form of prostate cancer in some people so make sure you discuss that with your doctor. The trade off at my age is worth it since my PSA have been consistently 0.9 prior to using Proscar. It also causes your hair to grow back, a side benefit for some. Best of luck to everyone.

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  • Edited

    I was reading posts here for a year or so before I had a TURP in Feb 2019. Many, if not most of the negative TURP posts were from people who had not had one but had heard bad things about that procedure. In other words, they were worthless. At 20 months out, I am still happy to have had the TURP. In the last year or so, there have been many positive posts from TURP recipients. Is it the right procedure for everyone? Of course not. But it is the right procedure for many (I also had a relatively small prostate but an enlarged median lobe.) My advice to anyone considering a procedure (or medication) to relieve their BPH symptoms is take with a grain of salt any post about a particular procedure unless that person has actually had it performed on them. And remember that most urologists do only one or two of the many surgical procedures so that's all they will recommend. If you don't like the advice you are getting, get a second opinion.

  • Edited

    Henry,

    I had a failed Urolift in 2015 and had a TURP on 9/18/20, so just over 2 weeks or so ago. Like yourself and Lee, my median lobe was the issue. I did my homework on all the procedures, trust me, and for me at least, this was the way to go. My recovery seems to be right on schedule. I stayed overnight in the hospital with a catheter and it was removed in the morning so I didn't have the catheter at home. I have seen my share of blood in the urine, some pain, some small clots (1 big one after 3 days post procedure) and now I'm starting to see some scabbing. My urologist/surgeon told me this is all par for the course. My stream is strong but I am still waking up several times a night to pee, but again, my doctor says that it takes a while to not only fully heal but to get the brain/bladder connection on the same page to recognize that the obstruction is no longer there. I stopped Flomax a week after the procedure. I couldn't care less about retrograde (even at the relatively young age of 60) compared to the disrupt that my BPH caused me for years. Besides, I have experienced it off/on due to Flomax and just don't think it's a show stopper. I've been thru too much in my life to let that get in my way.

    So far, so good for me and I'm happy to hear others with good TURP reports.

    Regards,

    Rob

  • Edited

    Hello.

    I had a turp in June 0f 2019 .

    I had an enlarged non cancerous prostate . I had 1700 mls drained at the hospital when my condition was diagnosed ..Initially it was not a great success and I had to carry on with C I C for nearly two months afterwards . But slowly and surely things improved to such an extent that by the October of 2019 I stopped CIC completely (partly because I couldnt physically get the dam thing into my bladder any more and I really don`t know why .

    Anyway here I am 16 months later and I can pee good although I usually have to void twice (the second time within 20 seconds and usually only about 80 mls.... unless I really have a full bladder which seems to stimulate the nerves and stimulate the bladder to really get working and I void virtually all in one go and fast too.! So I am still retraining my bladder and try not to go more times than I actually need to. I can go 5 hours during the day without a need to pee...

    I can sleep all night sometimes , but if I do wake up I pee then go back to sleep easily . I can sleep untroubled for six hours most nights before the need to get up and pee.

    I am glad I had TURP...I live in the UK and no other option was given me at the time...I am still happy with the outcome compared to what might have been if I had never gone to see a Doctor with my initial problem of urine retention...

    • Posted

      Hello, I had green light laser TURP 5 days ago and today they took out the cath. which hurts like hell when they put it in.They had me come back 5 hours later after drinking Three 16 oz. bottles of water .I still could not urinate ,just a dribble, so they had to put the cath. back in.They said I would have to come back in a week and do bladder empty test all over again. The dr. said too many months of not emptying my bladder streched my bladder and may take time for bladder to function right. He said I might have to self cath., but I told I can not do because it is way to painful, when the nurse does it the pain leaves me trembling. He then suggested cath. going into my bladder through my abdomen until bladder responds. I told him no way.Hope I can urinate better next week or I don't know what I will do.

    • Posted

      Will,

      Using catheters is not that bad. It is better than a cystoscopy, or someone else inserting the catheter, because you are in control and back off if you feel any pain. I was shown how to do it in a Urologists office, and started with the red rubber catheters. I did have some bleeding and a UTI the first time but after that everything was OK. I started using hydrophilic catheters after a couple weeks. It is not painful at all. I use Providone Iodine, and gauze pads, to clean the tip, but some others here use Benzalkonium Chloride wipes, such as "Wet Ones", available at Walmart. There are some good discussions about Intermittent Catheterization on this forum started by Jim James. You can search for them.

      Thomas

    • Posted

      Will if you cannot pee think about self catheterisation..you are in control and can take it easy and slowly . I did it for several months before my bladder finally took over . I now pee naturally and I am happy .

      I had to self cath for 10 weeks before a turp operation and for a couple of months afterwards .

      Me and my bladder are now in control though . It has been about 18 months now since the last time I needed to self cath..

      Good luck will !

  • Posted

    Hello. I/m a 58 yr old male in the U.S. I've suffered problems with urination for years. I had to urinate often with not much to show for it. Over the last 6 months or so, night time incontinence has been a problem.

    Went and had the workup. Shows the problem is retention due to a large mid lobe. My Urologist recommends TURP. I had bilateral simultanious knee replacement 11/19 and a couple surgeries w/o any complications. I've been using caths for a week. No issues 3x day.

    My biggest fear is the recovery will take away too much of the Spring/Summer. I like to golf and take care of general yardwork. I'm wondering if I should just continue CIC until say, November or "bite the bullet" now?

    Any thought are appreciated.

    Mike

    • Posted

      Hopefully you have moved forward and had the TURP by now. See my other comments and answers.

  • Posted

    Hi Henry, I was just wondering if you have an ultrasound done before the procedures and did they found nodules in the different zones of the prostate or not? Also the PAE that you had, what is the reason given why it didn't work well?

    Thank you Ronald

  • Posted

    Hi Henry78175, Your surgical TURP is better than most I read. Was it green light laser TURP?Thank you for sharing .

  • Edited

    If a patient doesn't care about the risk of RE and can tolerate general anesthesia or spinal block, TURP is usually a one and done option with great results. Like most prostate surgeries you need to be prepared for some short term misery. But once the tissue has healed and bladder has settled down, most men say they wish they'd done it earlier. I had an aquablation which is a form of TURP in that it creates a large cavity, and that's how I feel, too.

    Also take what you read on forums like this with a grain of salt, even if it's written by someone who had the procedure. 150,000 men get a TURP each year in the US alone. You read the outcomes of maybe a couple dozen here each year. Those who had not so great experiences are more likely to get on the internet and let everyone know about it.

    • Edited

      I can't say this often enough, there was no pain or "misery" for the TURP procedure. My only advice is leave the cath in for 2-3 days after TURP. This allows your prostate to shrink from the swollen state it is in from the procedure. It just makes life easier.

  • Posted

    All,

    I got off the site and allowed my self to heal completely without any outside influences. My TURP was entirely successful. My previous procedure of a PAE was successful to a degree and my flow improved. The flow improved remarkably with the TURP. The PAE was done by Dr Bagla in April 2018 and the TURP was done May 2020 locally. My only issues was an off and on again symptoms that I thought was UTI. After awhile antibiotics failed to work. I ran through other medical evaluations and discovered I had kidney stones, calcium oxalate type, and they were as small as a grain of sand. That started my next adventure of trying to manage kidney stones. I went back to Apple Cider Vinegar and then tried lemon juice. It all helped for awhile, but the issue kept returning. They symptoms are painful urination that feels like it runs the length of my penis from tip to bladder. Of course it includes the multiple trips to the bathroom nightly and just kills your quality of life. When I am not passing a kidney stone, life is good and very normal. The finasteride 5mg the urologist put me on has eliminated my PSA score to a negligible score of <0.1. as of one month ago. I discovered two over the counter items that have been working very well for me on the kidney stones issue. No symptoms at all and no pain and no urgency that accompany kidney stones. I take Chanca Piedra (Stone Breaker) 1600mg and Cranberry Concentrate 15,000mg with Vitimin C. The results have been excellent and I am back to a normal life. The PAE, TURP and finasteride has noticble shrunk my prostate. The OTC supplements have eliminated my kidney stones by keeping my kidneys clear and not producing stones and the Chanca Piedra breaks stones allowing for easy passage, no pain and I love this stuff. Based on an Australian doctor experience with UTI issues with his patients, he wrote in one of his analysis that if you can not get your UTI under control, have a blood test for Herpes since it can lounge in your urethra mimicking all the UTI symptoms. So I had a blood test. It was all negative and shortly after that was when I discovered the kidney stones. This is an update March 31, 2022 from Arizona, USA

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