Turp vs. Green Light and Other Less Invasive BPH Procedures

Yes, from what I've read so far, it does seem to be a good alternative to both TURP and Green Light. Thanks for weighing in.

As I've mentioned my lengthy and sever incontinence to the point, I fear, of sounding like a broken record, I must in all fairness repeat an important statistic.  In a paper by Dr. Drogo K. Montague of the Cleveland Clinic, he wrote, "Urinary incontinence occurs less often (than for a radical prostatectomy) after transurethral resection of the prostate being a significant problem in only 0.5% of 3885 men 2 months following surgery."  So I'm apparently one of the unlucky 0.5%.

Hi Paul, I'm a bit confused did you have HOLEP? You say your prostate was 46 grams after HOLEP, correct? Gee, mine is only 50 grams to begin with. Other than leakage how long before you were trouble free after surgery? How long after surgery until could you have sex?

Thanks for the thorough report, Paul. Sounds like HoLEP has worked well for you. My uro here in Washington DC is one of the top docs in the area and a very nice guy to boot. But I don't think he does HoLEP. I'll continue researching the issue. In the meantime, my meds--Finasteride and Cialis--still work reasonably well, so there's no urgency, but at some point I'd like to be drug free. Here's wishing you continued improved health.  

Very sorry to hear about your unfortunate experience, Glenn. What are your options at this point? One thing I don't understand about your procedure. You described it as a "Green Laser TURP." I thought Green Laser and TURP were two different procedures. Is there now something called Green Laser TURP?

Hi Don, How long were you on finisteride and cialis,glad to hear it works for you?I have urine rentention , been on Avodart,and flomax,4 months,still have a cather in.,still canot urinate.Did you have urine rentention?How soon did the medicine start to work for you?

thanks for this info/

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I just view it as a variety of TURP.   Instead of the resection via cutting, the laser vaporizes prostate material.   My second procedure was Gyrus TURP.  Some urological centers call it Gyrus TURP, and others call it Gyrus Bipolar Electrovaporization.  Just a matter of naming. 

Don how is the cialis working? I assume you aren't on flowmax with the cialis due to blood pressure dropping too low. I got a sample but have been afraid to stop using flowmax since it works well. 

I would go for the Cialis as it's main side effect is beneficial:-)

When I was given Flowmax many years ago It lowered my BP and put my heart rate up to the 130's in just a few days. Strangely Tamsulosin did not have that effect.

 

The Cialis saved me from surgery. I was on Doxazosin, along with Finasteride, and it worked for several years, but I had to keep upping the dosage. When I got up to 8 mg, the side effects (mostly dizziness) were so severe, I stopped taking it. I was on the verge of Green Light, when I heard about Cialis as a med for BPH. I started taking it and it started working right away. I've been on it (5 mg. daily), plus Finasteride (4 mg,) a day, for about three years now, and except for occasional prostate flare-ups, I've been doing pretty well. The one issue with Cialis (at least in the US) is that most insurance companies don't cover it. (Mine--United Health Care GEHA--is one of the few that does.) Funny story: A couple of years ago, I was in Greece, and out of curiosity asked a local pharmacist about Cialis--price, insurance coverage, etc. He said that insurance in Greece used to cover Cialis--and then every man in Greece suddenly had an enlarged prostate. So now it isn't covered.

Thanks Don.    Just to reiterate..... staying on the drugs for too long can damage the bladder (from what I've read here and elsewhere).  My uro here in WA added finasteride to my flomax when symptoms worsened, but it slowed my blood flow so much I had cold feet and tingling in my fingers..... pretty scary.  I stopped taking that and went on dutasteride which did not have that side effect.  I was going to do TURP with him as I really liked the guy, but our schedules didn't mesh for a couple years (I spend most winter months in AZ), so I finally went to Mayo Clinic in Phoenix after learning about HoLEP.  SO glad I did.  However, it's only been 9 months so in some respects the jury is still out on a the need for an additional procedure.  But, I've not read from anyone here the need for a repeat after their HoLEP.  We'll see!

Frank, Cialis (5 mg. daily) worked for me almost immediately. I've never had retention, though before Cialis, when I was on Doxazosin, I came close a couple of times. See my reply below to uncklefester, for more details.

Fester.... yes, I had HoLEP last January,  Yes the prostate was 46 gr afterwards.  Other than some minor bleeding and leakage that stopped after 2 or 3 weeks, I had no issues.  I held off from sex for 4 weeks as they advised.  I also realized the drugs had almost totally killed my sex drive, which then returned.  Great to be 'normal' again, at least in this department!

Glenn..... that's an interesting stat, and no surprise that any surgery is not perfect.  However, I don't think we'll ever know the real reason for the 0.5%; i.e., was it a botched job, or just some anomaly with the patient's body?  That's why I really press everyone to check out their docs as best they can even though most times it's probably not really possible.

I agree and am reluctant to blame the doctor since I requested the GL procedure.   My only beef is this.  I had called the week before to ask about the GL since I was concerned about dealing with on-going bleeding.  I only was able to talk to his nurse, and I had said that I would really prefer  the GL if possible since I had some committments (singing with church choir)  10 days after the GL.  The nurse called back and said he would do the GL procedure.  After the post surgery issue of ongoing urinary incontinence problems became apparent, he offered that he had almost said no to doing the GL.  I responded that I would have accepted your judgement on that.

When he did a cystoscopy about 2 months after the GL, I was able to crane my neck enough to see that as the camera passed into the prostate, with the water flowing, it looked as if it was going through underwater tree roots.  That's because the GL procedure left a lot of still attached pieces of prostate that were causing irritation.  So a second procedure was required to clean the mess out.  

Someone wrote last night that his doctor had said the GL procedure has a much longer recovery time (than conventional TURP) to return to normal.  If that's true in general, I would have never elected that path.

15 years ago, my first dose of Flomax rendered me unconscious at church.  The rescue squad measured my BP at 65/35, and I was barely aware of their prescence.  They started saline solution on the way to the emergency department at the hospital where I received two more bags before being released about 4 hours later.

Nice story:-)

Two others when Viagra was being trialed for its original use for heart problems they gave it out to men in one area of Wales. When it was found not to be very effective for its original use the trial was stopped. The men had all found that Viagra had benefited their sex lives and demanded to stay on it and the makers relented.

One Christmas eve I went to collect a prescription from my GP's surgery.

There was a massive gleaming motor bike parked outside and its young  strapping leather clad young rider was ahead of me at reception. The receptionist could not find his prescription in her box and asked when he had put in his request. He said yesterday and the receptionist told him that it takes three working days for them to be done and being Christmas he would not now get it until after the holiday that also had a weekend in between .

Was it something urgent she asked him. Cialis he whispered. She gave him a sympathetic look and said I'll see if I can find a doctor to sign it for you now, 

You need to keep posting, paul20443.  THANK you.

I will when a 'newby' comes along, or I find new information that may be of use to all.  I wish there were a way to reach all men having to deal with BPH..... there's obiously a lot of experience here!