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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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  • caringbah
    caringbah MK51151

    Posted

    MK, whatever you do. DONT have TURP until you've checked out PAE. I had BPH and went to three urologists...one wanted to do TURP, another wanted HOLEP and the other wanted to do open surgery on me. 

    All were bad optIons In my view. The problem was UROLOGISTS ....they will never tell you about PAE because they are not qualIfied to do it. 

    PAE is carried out by an Interventional Radiologist. They block the arteries feeding the prostate and the reduced blood flow shrinks the prostate so you can pee again.

    I had mine a year ago and couldn't be happier. No cutting, no bleeding, no incontinrce , no retrograde ejaculatio. It is a FAR superior option to TURP but the urologists won't tell you about it because it's a threat to their wallets. 

    There me is a very large discussion about PAE on this site...check it out and make an informed decision. 

  • jimjames
    jimjames MK51151

    Posted

    I see a lot of similarities to what I went through a couple of years ago. Short answer is seriously consider delaying the TURP to give yourself more time to explore some of the newer non-evasive options. And if none of the options appeals to you, then consider waiting a little longer. This assumes that you are tolerating the self cath regimen which should become second nature within a couple of months even though it sometimes is a bumpy road in the beginning.

    I cancelled my recommended TURP almost three years ago and have been self catherizing in the meantime waiting for better procedures, less invasive procedures without the sexual side effects. In place of the TURP I also went on a self cath regimen and in fact it has rehabilitated my bladder to the extent that I have gone weeks, even months without having to self cath. 

    Unfortunately, most urologists only see self catherization as a short term solution either pre-op or post op. But in fact it can be a valid and effective longer term solution either permanently or at least until you fine a procedure or operation you like. 

    Hopefully they took you off the drugs now that you are self cathing. Really no need for them since self cathing allows you to empty your bladder completely on demand. 

    Jim

  • tim07875
    tim07875 MK51151

    Posted

    I have a very positive reply for you to consider. I had a TURP done on 10/13/15. Like you, I had similar symptoms, frequent urination, some burning, never being able to "feel" as if my bladder was empty. Urolgist did a cycsto and said my prostate was one of largest he had ever seen (not the world record though). I had a green light surgery some 10 years before that did absolutely nothing, other than cause lots of bleeding, very painful urination after the procedure, etc. For my TURP, urologist had me on the table for about 2 hours, mostly cleaning up scar tissue from laser treatment. Removed 55cm of prostate. Overnight stay with a catheder and loads of fluids. The following morning I was urinating mostly clear, no clots, sent me home. The worst part of the TURP was this. For about 2 weeks after the procedure, you are passing blood, and when your bladder is almost empty, there is a considerable amount of burning that lasts about 10 seconds. I did not take any medications other than an antibiotic which was just a safety measure against infections. They prescribed a pain pill, didn't need it. The bleeding stopped after about 2 weeks, and the post urination burning was completly gone a week later. You should note that after the procedure, you'll have very little bladder control, so stay near a bathroom for the first week or so. There are strengthening exercises your physician will discuss (called Kegals) which will get your bladder control back more quickly. I am THRILLED with the result. No more multiple trips to the bathroom each evening, when I urinate, it's like I was 16 years old again. Great stream. One other caveat, and I've seen some guys on this forum be upset about this. You will have a retro ejaculation, which simply means when you ejaculate, nothing comes out. The sensation is identical, just not the mess. So be aware that if you intend on having children, a TURP is not for you. I think it's hugely important to make sure you find the right surgeon. I think so many complications arise (like my laser experience) when the wrong doc is holding the scapel. Ask some pointed questions, how many has he done, what risks am I about to encounter? etc. My doc told me he'd done several thousdand TURPS in his 28 year career. 

    One final point. In my case, before surgery, when I ejaculated, the burning pain was really bad. After the surgery, that pain is gone.

    I'm sure you've read the bad news on this blog, I can honestly tell you that my experience was very, very positive. I wrote this one time and some guy wrote back that I was one of the "lucky" ones. Maybe. My dad had a TURP 25 years ago, my older brother had one, now me. None of us had the poor experience that some guys write about. I wish you all the

     best, here if you have additional questions. 

    • Motoman
      Motoman tim07875

      Posted

      Good post Tim. I see the same people bashing procedures over and over, but never had the experience themselves. It is usually about retrograde ejaculation. But at the age of most of the people on here, we are not having kids, and probably not as much sex as we used to. But peeing when you want to is a very important function if you want to have any type of life or freedom.

      i haven't had TURP, but wouldn't hesitate if I was using catheters to get off them. 

      Now if I was a porn star, I might have to put the TURP  off.

    • tim07875
      tim07875 Motoman

      Posted

      Hey, thanks for the note. Medicine is a moving target for sure. What works for one guy may not work for another. I'd had a vasectomy done 20 years ago, so kids were off the table for me anyways. All I can honestly say is that my TURP was the best decision for me, and I could not be happier with the result. When I spoke with my doc about the possibility of having to go through it all again, he told me unless I live to be 90 (I'm 62) I'd be fine. Dad had a TURP when he was in his 50's, he's 87 today and has a bladder like a camel. I agree with you 100%, the thought of having to cath myself to urinate is beyone what I'd want to deal with forever. 

      For me, it worked out well. I still beleive that the surgeon is a huge piece of this puzzle. Like I mentioned in my original post, the guy who did my green laser thing I learned later had only done a handful of laser treatments before me, and he had only removed less than10% of the tissue. My current doc (also in the same urology group) simply felt that because the laser at that time was the "newest, latest, greatest" the previous doc was hesitant to do too much. Truth be told, the recovery from the TURP was easier and less painful than the laser. Neither were a walk in the park,  but it all went well for me. As I tell everyone, find the guy that's done a ton of them, there are many ways to look at a surgeons record, etc. I did my homework as best I could. I would recommend my guy to anyone.

      Now, about that porn star thing......I burst out laughing. Stay well...

  • oldbuzzard
    oldbuzzard MK51151

    Posted

    I would lk into less invasive procedures before doing the TURP. Ask to be referred out if your urologist doesn't do them. If RE isn't a problem, people seem to have great results with holep. If it is, try the PAE, Urolift or Rezum if you can. THey aren't as sure fire as someting like TURP - but its a very invasive procedure and while your mileage mahy vary, RE makes sex less enjoyable for me.

    You can always do the TURP (or Holep which seems to be far better in every way) if the less invasive things don't work.

  • cartoonman
    cartoonman MK51151

    Posted

    I am another who was TOLD by my urologist (Aug 2014) that he was going to schedule me for a TURP.  I already knew of the side-effects, and awful possibilities, and just said NO.  Last December I had the Urolift done.  It's the only procedure that can be reversed, with no side effects if done correctly.  I would recommend holding off on the TURP until you have checked out PAE, the Urolift and other options, as there are plenty of reports on this site by guys who were TURPed, and are sorry.  I'm glad to read these reports that some guys had good results, but the TURP is over-pushed by self-serving urologists.  Read more, then make an informed choice...

     

    • MK51151
      MK51151 cartoonman

      Posted

      My insurance does not cover neither one of this two procedures and it considers them still experimental. If you don't mind, would you tell how much you paid for your Uro lift and if insurance company paid anything?

      I inquired by one od Texas urologist who performs a Rezum and got quote  just under 6 grants. I don't know if it's worth to spend this much and year or two down the raad still need TURP while having monthly payments for Rezum.

    • kenneth1955
      kenneth1955 MK51151

      Posted

      So just because your insuance  does not cover it your going to have something that you may not need.  Your sex life will never be the same. cancel that procedure.  some men that have it done say that it's bad and they don't feel like having sex because the orgasm is dull   PLEASE CANCEL BEFORE IT'S TO LATE  ken   
    • cartoonman
      cartoonman MK51151

      Posted

      I got mine via Medicare (I'm 66.) I believe my doc said it's normally $3,500-$5,000, depending on the number of implants.  

      This procedure was okayed by the FDA three years ago, after years of use in Europe.  It's NOT "experimental;" I would suggest challenging your insurance company about it, and/or looking for another carrier...

    • MK51151
      MK51151 kenneth1955

      Posted

      Nicely said. Yes, I can cancel TURP but what than? Risk to suffer kidney damage and be dyalysis dependent or take a loan to afford something else.

      Definitely, I want something less aggressive but my question is how to pay for that. I do not know how average earner can afford better surgery. If you know any financial trick or good advice, I would appreciate it. To be honest, I am foreigner and maybe I need to learn how others maid it possible to happen.

    • kenneth1955
      kenneth1955 MK51151

      Posted

      First of all please  cancel  turp.Then look at the other options.  Life is to short to give something up.   Did your doctor tell you sometimes the first turp will not work and you may have to have 1 or 2 more.  Think about it.  With CIC they will show you how to do it.  A well lube catheter will not hurt you.  This will give you time to look and get some information on  PAE AND UROLIFT.  Both are approved with the FDA.  IT only cost me 200 dallars and payed it in 4 month's.  Think about it please before it is to late.  You said you have 8 - 10 good years but that will all change when you have the turp.  It will be very dull and some men give up sex because they feel nothing.  I had it with a pill and it is true.  Please take your time...Ken 
    • Motoman
      Motoman kenneth1955

      Posted

      Just to offer a different viewpoint, you give something up by having to use a catheter also. Freedom. 

      And I doubt, but don't know this because I haven't had TURP, that the retrograde ejaculation from Flomax is the same as from TURP. I have had it from Rapaflo and Flomax. So unless someone has had it from TURP and Flomax it is just speculation. 

    • MK51151
      MK51151 kenneth1955

      Posted

      Taking Tamsulosin twice a day I already experienced anorgasmia (no ogasam at all or very little of orgasmic sensation) RE, partial ejaculation etc. I am just wondering how much worse it could be?
    • kenneth1955
      kenneth1955 Motoman

      Posted

      I did not have a turp.  I was on Flomax got off that quick.  There was no feely at all Ken
    • kenneth1955
      kenneth1955 MK51151

      Posted

      Maybe if you do CIC you can get off tamsulosin for a while and enjoy life.  Please there is no harm in trying.  There are other med the doctor can try.. You can allways go back and have a turp......Ken 
    • cartoonman
      cartoonman MK51151

      Posted

      If you consider stalling for a better alternative solution, read up about "hydrophillic catheters."  I use "SpeediCath," and have since August 2014.  There are other similar types.  They are made of silicon, and are pre-lubed, as Ken says.  Do NOT consider rubber; they hurt and easily cause injuries.  Single-use silicon caths are the way to go.  It doesn't interrupt my life nearly as much as the possible TURP side effects would have!
    • MK51151
      MK51151 cartoonman

      Posted

      I use same brand and type of catheters. Fast and easy catherization and also no pain and irritation.
    • cartoonman
      cartoonman MK51151

      Posted

      A friend of mine is also very happy with the "Magic 3," also hydrophillic.  I tried them, before finding the SpeediCaths.  The Magic 3 has a little packet of water, which the user pops, to release the water which "greases" the catheter.  Then there are a few seconds' wait, while the catheter soaks.  

      I had a problem with mine, only one, where the little water sachet was empty whem I popped it.  Left me thinking I needed to carry a spare, just in case...

    • kenneth1955
      kenneth1955 cartoonman

      Posted

      I have a friend that has been doing it for 20 year.  He said no to a Turp years ago.    I think his 65  Ken
    • MK51151
      MK51151 cartoonman

      Posted

      I am glad your procedure was covered by Medicare. Looks like Medicare provides better coverage than my insurance. I will utilize what is available and I am aware of potential side effects related TURP. I think doing nothing is worse than side effects. To fix bigger damage always cost more....
    • MK51151
      MK51151 kenneth1955

      Posted

      I stopped tamsulosin 2 days ago and today is getting bad. Barely can pee few milliliters on my own with having burning pain and need to push a lot just to expell small quantity of urine. I think having catheter handy is good idea if I run into retention.
    • oldbuzzard
      oldbuzzard MK51151

      Posted

      You might want to consider that TURP is the most invasive and most likely to cause permanent damage of all prostate surgeries. You can always do a TURP, but once you do any side effects or problems are likely not fixable. Some people's symptoms improve a lot after self cathing for awhile and at some point your insurance may cover one or more of the less invasive options. Read the threads on TURP - some good results, but also a lot of misery. My suggestion is to try slef cathing, see if you can deal with it, see if things settile down and ask your in network urologists if they might get training in Uroloft, Rezum or HoLep.
    • jjjj57989
      jjjj57989 derek76

      Posted

      Do you take Cialis daily?  What dose?

      It always gives me a headache so I haven't tried it yet.

    • cartoonman
      cartoonman MK51151

      Posted

      I don't recall whether you already cath.  As maybe I mentioned before, and Jimjames has probably seconded, self-cathing is an easy art to master, WITH THE RIGHT CATHETERS, and buys you time, WITHOUT SIDE EFFECTS.  SpeediCath or the Magic-3 are two excellent choices.  EIther you are retaining a lot of urine (common problem!) or you have a UTI (urinary Tract Infection---also common problem!)  Retaining large amounts of pee can cause permanent damage (the bladder loses its ability to shrink back to "normal" size; easier to get UTIs), so please consider and take seriously the counsel of us civilians who have been there already... This ain't a place for you to screw around.  Just sayin'...  :-)

       

    • derek76
      derek76 jjjj57989

      Posted

      The daily pill is 5mg. I can't take it at the moment as it is contra ndicated with with another drug I am taking for another condition. When I was taking the 20mg pill my flow was always greatly increased for the next two days. I was lucky not to get any side effects from it.  
    • jjjj57989
      jjjj57989 derek76

      Posted

      Thanks.

      Were you ever able to try the 5mg?  Did it help?

    • derek76
      derek76 jjjj57989

      Posted

      I didn't try the 5mg but a friend has been taking it for the best part of a year and has a much improved flow.As his flow has slowed down his prostate must be regrowing 11 years after his PVP.
    • MK51151
      MK51151 derek76

      Posted

      Yes. I did. It did not work well helping me with ruination but certainly it helped  with erections. Tamsulosin is helping me better with urination but it is not as effective as it used to be a year ago. After having PVR of 450 cc my urologist increase dose to twice a day but I can tell is not effective as it used to be. Prostate is indenting my bladder and median lobe is growing into the bladder.
    • MK51151
      MK51151 cartoonman

      Posted

      Yes, i do straight cath since beginning of April mostly twice a day to empty my bladder completely. I am using speedi cath and it is really easy and pain free but I do not to do it forever.
    • derek76
      derek76 MK51151

      Posted

      Tamsulosin reduces sperm output and causes retro. It can also cause floppy iris syndrome making cataract surgery more difficuly.
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