University level Urologists.

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Had a Urolift done 1 year ago, terrible flow, pressure and volume   Still retaining 400 cc after feeling completly voided..    Started self cath about a month ago and do it before bed and when I get up in the morning.  Sleep all through the night no problem.

     My Uro doc, in Fresno decided to refer me to a Universiy urologist,    I appreciate the fact that he never suggested any surgery.    I'm 57 and have been dealing with BPH for 15-20 yrs and have been on Tamsulosin the whole time,  and cut back on it since I started self cath.   I believe that my sex drive has improved since doing that.

My question to y'all is has anyone been seen at a University level urology group?   I have been referred to San Francisco University.   Just looking for some feed back.   

Thanks.    Anthony

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  • Posted

    Tony.....I’ve been following this blog for about 5 months and have heard a lot about cathing, drugs, and the various BPH procedures.  All useful info. Bottom line:  drugs may work for a while (for me it was about 2 years), but the answer imho is surgery, specifically HoLEP.  I did the research on all the procedures (except PAE….had not heard of it), and chose HoLEP.  It is the best surgical procedure because; 1) less time in the hospital and a on catheter (less than 24 hours), 2) less bleeding, 3) very small chance of needing a repeat procedure, and 4) they remove prostate tissue (instead of burning it), so they can biopsy it for cancer.  You do need to find an experienced doc to do this.  I too was retaining close to 800ml, and my prostate was 85 grams, PSA 3.8.  After it was 46 grams, PSA 0.2.  I had my surgery in January, and now have no problems at all.  Best of luck!
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    • Posted

      Hi Paul

      I had the PAE done in Uk on FEb 9th this year. REason being I have BPH and had Acure (total) retention twice last year and had to have an In dwelling catheter in place for 3 months!

      My 3 month follow up MRI showed reduction of Prostate of 20% from 82grams, symptoms now under control.

      My question to you after the Holep is has your sexual function been in any way compromised, eg REtrograde ejaculation or any other issues?

      If you wish to PM me then please do,

      thanks 

      JEremy

       

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    • Posted

      Jeremy..... yes you get retro (but no other sexual function changes) from all the surgeries..... for me, at 68, not a problem. From what I've read here, botched surgeries are another problem. PAE sounds like one of the few possible non-rugical solutions I would have tried had I known about it.
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  • Posted

    Anthony,

    If you are still having issues after the Urolift then something else is going on - possibly a median lobe extension into your bladder. The UL pulls the prostate away from the urethra so you will need a thorough exam. UCSF is one of the top urology departments in the world and they have all of the very advanced imaging techniques - if you go there you really could not be in better hands. 

    Once you find out exactly what is happening and if you decide on HOLEP you will have to get it outside California - closest place would be the Mayo Clinic in Phoenix. 

    However, until you have the tests and imaging it's really too soon to be making any treatment decisions.

    Best of luck to you. Glad to hear the self cath is working for now. 

    Tom

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  • Posted

    Since you are predictably retaining after you void, you may have a slack/stretched-out bladder.  I have such a beast, that, after years/decades, maybe of holding too much pee, will not return to a truly empty state.  Instead, it will hold up to 500-600 cc without complaining, and twice in the past month I've "caught" it holding 1,000cc!!!  

    I too cath morning and night, and have started cathing midday as well, as it's a good idea to not retain large amounts of golden liquid.  "Jimjames," a frequent commenter, has his own thoughts about cathing MORE frequently, to bring the risidual amount down even lower than 300cc and give the bladder a chance to shrink itself.  He wrote that after two years of dogged draining, he managed to shrink that bag down to normal.  (Of course, your mileage may vary.)  I have gone from cathing only at night, to cathing first thing, midday and nighttime.  And if I want to try JimJames' approach, I will cath until I get it below 300cc each time, and then keep on going!  Not easy... and not what the doctors propose...

    And be thankful for the upside:  At our ages, sleeping through the night is its own blessing!  :-)

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