Urolift For Prostate Median Lobe

So Jonboy, so you had the lobe removed along with the urolift and not issues, correct?

Royce, had it tied back , no cutting .

Thanks for your input Kenneth.

No problem Royce.  Do not let them talk you into cutting the bladder neck or clipping it open.  That does not help.   All that does is cause problem.  In the trails for the median lobe they did not do that they clipped it to one side.  Good luck  Ken

The doctor who ties the median lobe with the urolift says say when then they actually get in there with the cystoscope, if there is a high bladder neck it may need a little cut.

Tell them no.  Once they get the median lobe out of the way it will open up the bladder neck.  Do not let them do that because you will end up with retro and you may as well not even have the Urolift.  It will be a waste of the procedure.  The Urolift was developed to save your sexual function and Your ejaculation is a sexual function. The doctors to not consider your ejaculation a function.  They say we don'e need it if we are not having kids.  Please be careful.  Ken 

Hey Buddy.  Did you find a new doctor yet.  What ever you do to not let them touch your bladder neck  That will cause retro.  Good luck and have a good day  Ken 

Kenneth, I have made a decision weighing all different options. The Dr doing the urolift on the median lobe is the best in Australia but he told me there is a failure rate o 20% and he couldn't guarantee that it would be long term. I have decided to go here with a urologist who will just excise the portion of the median lobe in the bladder and do the urolift on the lateral lobes opening up the urethra. He said there is a low risk of either continence issues or retroejaculation because he won't be incising the bladder sphincter and the ejaculatory ducts are below the neck of the bladder.

I just couldn't see travelling all the way to the other side of the country; all the costs involved and hoping that it would succeed. Everything works to some degree. I have heard of failures with FLA, PAE, Urolift, Rezium, etc. I always had this thought, knowing the anatomy, why you couldn't one just cut away that portion of the prostate without doing the full TURP. Well that's exactly what he is doing. It was also recommended by a second urologist but he wanted to do a cystoscopy before as a separate procedure. I couldn't see the use in that since I have already had two cystoscopies in the last few years, a couple of ultrasounds and MRI. The problem is pretty obvious.

I hope it is not Dr Chin.  I don't know if that is going to work.  Pinning the median lobe to one side will work and save your sexual function and ejaculation   What he is doing is cutting the median lobe out.  I did a little checking.  The median lobe is part of the central zone and so are the ejaculatory ducts.  How is he going to guarantee you will not get retro.  If I were you I would tell him I just want the Urolift for not.  You have to give it a chance.  I feel sorry for you if he does what he want. Remember it is your body and you need to stand up for it.  Also remember that you are the one that will have to dealing with the side effects Good luck  Ken

Dr Chin was the one in Wollongong who was going to tie median lobe to lateral lobe. They just didn’t sound confident enough for my liking. 

The guy doing mine is not removing the whole median lobe, just doing diathermy on the protruding portion. The ejaculatory ducts are not in that area. He has done many of those and Urolifts. Even with Urolift there is a slight risk because it is retracting and compressing the lateral lobe which could compress the ejaculatory duct.

Anyways made the decision and feel better about it.

It is up to you    Dr. Chin was talk to by Ted which was one of the inventors of the Urolift.  They will not stand by the Urolift procedure if it is done with another procedure  Guess I will have to talk with him again.  But you do know that the median lobe and the ejaculatory duct are in the same zone. About the Urolift the only way you can get retro with Urolift if the doctor put the bar to close to the bladder neck.  Look it up.  Also when the doctor puts the clips on the prostate he does not touch the ejaculatory duct ( Veru Montanum ) because they are in the center of the prostate and it is unite buy the Urethra..He may not touch that but the median lobe is connected to the other lobe and at the bladder neck you have the seminal canal.  Hope he misses that for you.  Well I did what I wanted to do I can only give my opinion You made your what ever happy you will have to deal with it  Good luck  Ken  .        

So only that part of the medium lobe that protruded into the bladder will be cut away. Will the remaining medium lobe still significantly obstruct the prostectic urethra?

Yes, he is just trimming back the portion protruding into the bladder which acts as a ball valve which semi-occludes the urethra. Also he is widening the urethra with the urolift, which pulls back the lateral lobes.

I agree with Ken that any resection of the prostate carries the risk of RE. Our understanding of what causes RE is not complete. The best ejaculaton technique still has about 10% of RE.

u seem to have made the best possible decision. Good luck!

if aqubaltion is accessible to u, it may be considered to take out the protruding medium lobe. The technique is heatless. GLL is known to have more precise cutting than TURP.