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Upcoming TURP surgery

Posted , 17 users are following.

MK51151
MK51151

i am 51 year old and for the past 3 years I am under the care of a urologist for my prostate issues. I am having difficulty urination for past couple of years with urgency, frequency, pain while starting the stream, dribbling at the end and feeling of incomplete emptying of my bladder. For urinatind at night that was between once or twice.

My first CT abdomen and pelvis in June of 2013 showed slightly enlarged prostate with calcification in the prostate. Follow up cystoscopy in August of 2013 was remarkable for partial obstruction by lateral lobes of the prostate. No trabeculation in the bladder.

My first PSA in July 2013 was 0.92.

i continued to have problems and saw urologist in June 2014 after having acute prostatitis in May 2014. PSA checked again in October of 2014 and it was 1.85.

I had few times gross hematuria in between the visits so I sow urologist again in June 2015 when another CT abdomen and pelvis with dual contrast was ordered. CT showed that my bladder was normal but indentation by the prostate was noted. Prostate was slightly to moderately enlarged and contained calcification so that were slightly more prominent than on last CT. Prostate was 3.7 x 4.7 cm and was producing indentation upon the base of the bladder that takes the appearance of an intraluminal lobulated mass. Cystoscopy was performed in July 2015 and revealed complete obstruction by lateral lobes and median lobe. No trabeculation and no abnormalities in the bladder. Finesteride was added with tamsulosin that I started in June of 2014. Urologist advised TURP what I declined.

In 2015changed my job and insurance and started seeing new urologist which is very young just completed residency. I had a lots of side effects from Finesteride and was told by new urologist to stop it. On the same visit my PVR was measured and was 223 ml. New urologist increased Tamsulosin dose to 2 pills one in the morning and one in the evening. Was scheduled to see him again in 3 months. February 2016 visit my bladder was containing 450 ml PVR. I was asked to urinate again and second reading showed PVR 354. In mid March I had my third cystoscopy which revealed obstruction by prostate "kissing lobes" and bladder trabeculation grade 1. Advised on TURP again. Had second opinion with a bit older urologist from the same group and he also advised TURP to fix my problem. On beginning of April I had acute urinary retention i

and went to ER where I was catheterized and 550 ml was evacuated from my bladder and prescribed self cath 4 times daily. 

Now, I am availing my TURP  June 1,2016.

i read on this and other forums many bad experiences and I am stressed very yah with this whole problem and upcoming procedures. Would like to hear some encouraging posts and good satisfying outcomes.

thank you all for contributing to this forum.

 

0 likes, 87 replies

87 Replies

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  • Kc110
    Kc110 MK51151

    Posted

    PAE was effective for me and restored my quality of life. Check out all the posts on this forum. It's worth a flight to Virginia to be treated by Dr. Bagla.
  • kenneth1955
    kenneth1955 MK51151

    Posted

    I m sorry that your having a problem.  Why did they not offer anything else If your lobes are touching you just need them separated.  A Uro-lift would do that.  I would tell them no to a turp .  Try something else first.  A turp will give you reto and it may lessen the sensation of your orgasm. At 51 you may not want kids but why should you give it up.  It's your discison  but look into PAE or Uro-lift  they tryed to do that to me at 47 I told them no.  I had a Urolift none in 2015 still  going strong.   To me it  like there pushing you into the turp Maybe that all they know........Ken       ld
  • surfman012
    surfman012 MK51151

    Posted

    Hi, as a start and as you are in the US, i would tend to agree with Ken1955...however i am a fit 68 yr old, and had a TURP standard  in March 2015..within 6 weeks i was back on my bike and out surfing...however a sensitive "feeling was with me on and off for 11 months or so! just the odd day of not feeling right, all that is now gone... and my water passing is marvellous,and sex is fine, some times i have R E!!, sometimes not, so everyone is different.But as i started, Ken1955 has the right ideas, think before you have a standars or Lazer turp,especially if other procedeures are available to you! And after any surgery, take it easy for awhile,and drink plenty of fluids...not alcohol!!! all the best, Syd
    • MK51151
      MK51151 surfman012

      Posted

      TURP was only offered to me. I tried to talk and ask about other options as Uro lift but my urologist was only advising for TURP as gold standard for BPH because other options don't have good truck according to my 2 urologists. It sims to me that (TURP) is only what is offered to average people without being able to pay bunch of money for something better. Insurance company here is dictating patient care. Sad.
    • kenneth1955
      kenneth1955 MK51151

      Posted

      That would be upseting to me to asking questions and the doctor walks out. Most of the men on here are telling to to cancel and looking into something else.  There telling you wht to do.  Ino  I don't what a TURP at 51.  The doctors should do what you want n what they want.  I on't care if you not haviny kids but no man want retro.  It lesson the sensation of the orgasm.  Please look into PAE and Uro-lift.  They would work or your problem...Tell them no..  Take care  Ken 
    • caringbah
      caringbah MK51151

      Posted

      MK, this is what I can't stand about urologists. TURP is not the "gold standard" whatever that means, it's yesterday's technology. If urologists don't know about PAE, they are ignorant, if they do know and don't tell you they are unprofessional. Either is no good. 

      I had PAE about a yea ago....fully recovered in 4 days....no cutting or bleeding. no retro or impotence or incontinence. I pee like a horse now. 

      There is a very big thread on this site re PAE....check it out...lots of guys have had PAE and shared their experience on it.

      I was booked in for Holep but cancelled three days before and had PAE. 

      Urologists will tell you lies about PAE because it threatens their incomes. 

    • cartoonman
      cartoonman MK51151

      Posted

      MK, check out your options!  PAE and Urolift are accepted procedures, and "Gold Standard" is exactly what my urologist called it, right before I said, "NO, THANK YOU!" almost two years ago.  It's BS, that they do that.  I flew to Salt Lake City (from eastern PA) to get treated by the most experienced uro-doc, for my Urolift in December, as nobody between NYC and Baltimore had much experience, and my situation was iffy.  TURP IS FOREVER.  If you were to have good results, great.  If you were to get those awful "side effects," you would have to deal with that outcome for the rest of your life.  Good luck with your decision-making!  :-)
    • MK51151
      MK51151 cartoonman

      Posted

      I just don't understand what is so good about PAE? Radiologist embolizes prostatic artery and prostate develops collateral circulation and starts getting blood supply soon so you have to do it over and over again and interventional radiologist is making money. If prostate tissue can regrow so it can develop collateral circulation. At the beginning right after embolism done it might be some improvement but not for long. That is why many patients don't have any improvent with PAE and months later do TURP.

       

    • Motoman
      Motoman MK51151

      Posted

      I thought that if you have a large median lobe, you are also not a good candidate for PAE.  

      i would throw out there that most people on this site are looking for answers, or whatever they had done isn't working. 

      The ones that had a successful procedure have likely moved on, and are out enjoying life. 

    • caringbah
      caringbah Motoman

      Posted

      Motorman, I had a successful PAE a year ago. Before the procedure I had lots of guys on this site help me in an invaluable way. I feel a moral obligation to assist in the same way. I am tempted from time to not even look at this site, but when an email comes in with some poor bugger contemplating a TURP because his urologist told him it was the gold standard, well I can no longer stay silent. 
    • kenneth1955
      kenneth1955 MK51151

      Posted

      MK What is so good is that it does work and it does not cause the bleeding and scare tissue that a TURP does. Did your Doctor tell you that sometimes a turp does not work the first time. Sometime you have to have it done again. Also somtimes it will take 6 month's to a year to heal. I bet they say nothing about that. You think your in pain now WAIT. You say the radiologist make money but so do the urologist. Who do you think sell the turp equipment. The signs are in the office. Thank god my urologist thinks more about his patients. I can't believe your in the US. Being told what you can and can't do. You have 2 weeks to make up your mind and what ever you decide you have to deal with the outcome. May god help you nake the right decision...Ken
    • kenneth1955
      kenneth1955 Motoman

      Posted

      The urolift company are also working on taking care of the median lobe ken
    • MK51151
      MK51151 kenneth1955

      Posted

      Kenneth1955, as the mater of fact I did not say a word about TURP being good and better then the others procedure. I said and I will repeat: I don't have a choice. That is what is offered to me and that is what my insurance covers. I will repeat myself: I would prefer something less aggressive but I am out of option. I am familiar with pros and cons of TURP surgery and I do not expect it to be walk in the park. If anything else would be available to me, I would be glad to call my urologist scheduler and cancel it. I am aware surgery day approaches soon..... 
    • Motoman
      Motoman MK51151

      Posted

      MK

      Just remember the advice you are getting here is exactly the same as what you paid for it...

      Once you make a decision, don't look back, and don't let the peanut gallery second guess you. It's your choice.

    • Motoman
      Motoman kenneth1955

      Posted

      I was commenting on PAE as was the OP. He said he had a median lobe protruding into his bladder. I was told PAE was not successful for that by the two docs I consulted with. 
    • kenneth1955
      kenneth1955 MK51151

      Posted

      MK I read it the first time I know you don't have a choice but you should. But before I have this done to me I would give the doctor a piece of my mind I think they get away with it because no one tells them no. Good luck with the surgery I hope it goes well for you and you can get your life back to normal. What hospital are you going into Ken
    • oldbuzzard
      oldbuzzard Motoman

      Posted

      I don't know what your financial situation is, but sometimes doctors will cut the price of a procedure if they know you're paying for it out of pocket. The good thing about the less invasive procedures is that they are less expensive - no OR, no anesthesia, no hospital stay, less follow up, etc. You might want to ask yourself what procedure you'd opt for given your pathology if all were covered, and see if you can get some qualified doc to do it for an amount that paid over time, you can afford. They other option is to have one of those docs appeal to your insurance company. They might agree because they will pay MUCH less for PAE, Rezum or even Holep than they will for a TURP. No guarantee, but its worth a shot.

      Remember - 10% chance you'll be impotent after TURP and a 5 % chance you'll have at least some level of incontinence - usually inability to control things when you have the urge. 20 TURP surgeries, 3 guys are either impotent or incontinent. I wish you the best, whatever you do, but I would suggest exhausting every other option - even the long shots like insurance appeal and begging docs cause you are paying for it yourself before facing those kind of odds. Ane remember, some who self cath get better after awhile without any treatment.

      Good luck - whatever you do I hope the result is ideal.

    • MK51151
      MK51151 kenneth1955

      Posted

      Surgery will be done at CHI St Luke's Hospital in Houston, Texas.
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