Urolift Procedure - February 2017
Posted , 35 users are following.
To give back to the onlilne community, I want to pass on some information about my Urolift procedure for BPH.
First the patient - I am 68, 6ft 172 lbs. I have had one BPH operation about 10 years ago (TUNA) from the same doctor who did the Urolift. Other signifcant conditions - HBP and hypothyroidism treated by medicine, Fairly active physically. Working very part time. Enjoying my children and, especially, grandchildren.
Impetus for the procedure - failure of tamsulosin (less than 1 year) to improve flow and with unsatisfactory side effects.
Confirmation procedure - Physician did a cystoscopy 4 weeks before the procedure to confirm this procedure was correct for the geometry of my prostate. Topical pain medication used. Was recovering well. Soreness while urinating was going away after a couple days. Was given 1 antibiotic pill. Either from my anatomy or something I did, it wasn't enough and I developed a urinary tract infection. Very painful 7-8/10. Needed additional anti-biotic. In a follow up visit 1 week before the Urolift procedure, things were better and we decided to go forward.
Urolift - Pre-Op: Was told to stop medicines (including herbal) that would contribute to bleeding - e.g., low dose aspirin and Lovaza (gen). I stopped the few other herbals that I took. Continued with the thyroid (levothyroxine) and BP (valsartan/hctz) - the latter was stopped the day of and taken later when I got home.
Surgery location - like many, this was done in an ambulatory surgery center, not a hospital. In my case, the center was run by the urology practice.
Procedure:
Cost - I am not going to focus on cost, because everyone's coverage is different. As I understand it there are 3 bills - urologist, anaesthesiologist, facility. The latter asked for a same day payment. The others bill.
Procedure schedule - 1:30 pm s
1)12:30 pm -- Reception review and confirmation of information and stoppage of food/water/medicines 12 hours before procedure
2) 1:00 pm -- prep for surgery, viitals, IV started. Met with urologist for last minute questions (mostly on activity after the operation). Met with anaesthesiologist - she doubled checked food/water stoppage and looked in my mouth (I realized post facto looking for dentures). Administered fetanyl - following was told by others
3) 1:30 procedure - was told it would take 30 minutes. My wife was shown before and after polaroid of the opening of my prostate. What she described looked like the photographs in the Urolfit pamphlet.
4) 2:30 pm approx - As I came out of the fetanyl, I was not as groggy as I expected. Strong urge to go, but nothing coming out. I walked to the bathroom myself holding onto the pole containing the saline feed for the IV. I had 4 bloody (medium) urine drops come out. They said that was enough.
5) Given instructions on post-op procedure - primarily minimal activity for a week. I was given the ok to do walking. Which I tried 2 days later.
6) Prescribed antibiotic for 5 days.
Ride home - I live 30 min. from the surgery center. We had plotted places to stop in case I needed to before I got home. Did not have to stop.
First day - very sore starting and stopping urine flow. Later that day it seemed flow was stronger, but hope might have colored my perception. Ate sourdough waffles (my wife is great) late afternoon. Ate a light dinner later. Forced myself to drink more water than I usually do (thanks to my wife) Sat up. Couldn't go to sleep until 3:30 am. Slept for 2 hours. Went to the bathroom. Slept for 2 hours. Note on clothing. Since I expected some bloody urine, I bought and used Depend pads for a couple of days until the blood stopped.
2nd day - soreness about the same as the cystoscopy procedure. Sign of blood was fading (didn't want to look too closely, though). Stream seems to be stronger (my wife said she could hear it too). Once I get the urge to urinate, I have to get in there fast. Urine flow starts quickly. Had to change pants once as I was not careful. Stopped the use of the Depends pads as there was no blood visible and I started having better control of the stream.
I will post follow ups. I am scheduled for a Uroflow PVR (check of flowrate) and urologist follow up two weeks after the procedure.
I am writing this to help people who are faced with the decision on what to do with their BPH. I am not an advocate for one procedure or another. This is a personnel decision. As you know, this is anecdotal. We are all different. Yet, we are also all the same. I would like to thank the others who have posted on this forum.
7 likes, 170 replies
dan55298 mark02906
Posted
Mark, thanks for the discussion... I am signed up to have a Urolift tomorrow. Woke up this morning with all kinds of stuff going through my head, remembered that I wanted to check out the MRI conditional info on Urolift, and looked into that. Then started thinking that the only reviews I had read on the procedure were off the Urolift website... hmmm... started looking for something more candid!
Boy, I found that here.
Would you prefer I not tell my story on your thread and start my own or should I add to yours?
I will start tonight, if you want my story somewhere else, just say so and I will move it.
First the MRI stuff... long story short, Metro Imaging told me that the gradient level called out on the Urolift site is too high, and I will never be able to get an MRI there again. This upset me a lot, because I have had three major concussions over the last 15 or so years, and did not want to be told if I have another there is no way to check me out. The good news is, after talking to three other imaging facilities, the last being the hospital I am having the procedure at tomorrow, I am much more at ease. The hospital guy said, "yeah, most implants of any kind cause an "MR Conditional" situation. He said that basically Metro Imaging will not be able to scan me because they have only open MRI machines. The hospital has both, and (I think open uses vertical vs. horizontal magnetics) the closed MRI's will be able to stay under the specified limit of magnetic field gradient of 1500 Gauss/cm, no problem. The 3.0 Tesla limit is not big deal, only experimental machines run more than 3 Tesla. So the guy made me feel much better about it. Of course the doc had said no problem already... yeah... he does not have one of these going into his body. LOL. I guess really he was right, however, he did not say anything about the card I need to carry from now on telling an MRI tech what my limits are.
So, tomorrow is the big day... The pre-op stuff says to take a shower tonight and tomorrow morning, and use an anti bacterial soap. Gonna do that. I had the scoping just a couple weeks ago, and that killed peeing for several days, some amazing pain. I think he dinged me. I did find the AZO stuff, that seemed to help, but turns your urine orange.
Oh and just for the record, I am 64 years old, weight is too high at 235 lb. and 5 foot 10 inches tall. I am in reasonably good health, but been trying all kinds of flow stuff... Flowmax was first, then Avadart, then RapaFlo... none were very successful, and especially the sexual side effects were really annoying with the two later. I ended up going back to Flowmax, but was taking a couple versions of Horney Goat Weed, along with Saw Palmetto, etc... never did try Super Beta Prostate, it was too expensive, but tried many "generic" forms of it. It came down to the flow test last week I needed to qualify for the procedure... I tipped the charts at 2 CC's per second... LOL I don't think it would have measured much lower!
I will check back in later...
Dan
mark02906 dan55298
Posted
bobbya dan55298
Posted
Dan, good luck with your procedure and post back ASAP. You brought up a very good point on MRI's, I can only use open MRI machines as I am very claustrophobic. Don't know what all the numbers and verbage your talking about. So, is your finding that having the urolift I CANNOT have an OPEN MRI ever again ?? This could be a game changer for me. Someone please advise, as I'm sure Dan will be not able to post for a couple days. Also, not sure of all the bad reporting on this tamsulosin medication, someone please tell me the issues/side effects with using this medication. Thank you in advance
bobbya dan55298
Posted
john568 bobbya
Posted
bobbya john568
Posted
O, I was not aware of that !!! I have only been on it for a couple/ three months, thankfully no issue yet. I sure don't want that to happen, I have a very active love life. Thank you for sharing that piece of valuable info I didn't know.
dan55298 bobbya
Posted
the numbers I found on the MRI stuff were on the Urolift website... under the FAQ section I think... and as I understand it, at this time, I will be limited to non-open MRI's from here on out. Yeah, a problem for me also. the last time I had one that was not open, I did not do well... I am claustrophobic also! you can work with your facility though on that. they will let you take valium or something to relax. that is what I intend to do after this.
dan55298 mark02906
Posted
Dan
bobbya dan55298
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dan55298 bobbya
Posted
Bobbya, here is the info off the Urolift website... this is what I read to the folks at the MRI facilities. It might be possible to have open MRIs at some other facilities, but Metro Imaging in the St. Louis area has only a certain open machine which does not meet the gradient spec... from the FAQ page...
+++++++++++++++++
10. Will the implants interfere with having an MRI?
Non-clinical testing has demonstrated that the UroLift® Implant is MR Conditional. A patient with this device can be safely scanned in an MR system immediately after placement meeting the following conditions:
Static magnetic field of 3.0 Tesla or less
Maximum spatial field gradient of 1,500 Gauss/cm (15 T/m) (extrapolated)
Maximum MR system reported, whole body averaged specific absorption rate (SAR) of 4 W/kg for 15 minutes of continuous scanning (i.e., per pulse sequence) (First Level Controlled Operating Mode)
Under the scan conditions defined above, the UroLift Implant is expected to produce a maximum temperature rise of 2.4°C after 15 minutes of continuous scanning (i.e., per pulse sequence)
+++++++++++++++++++
Every facility I called (four of them) had people very willing to talk to me about it. Metro imaging had a phone tree which I left a message on, but they did call back a couple hours later. The rest of them patched me right though to someone who knew what they were talking about (usually an MRI technician)
On the "scope" question, I got what Mark got I think. Basically he put an optical tube up my front end, and looked around. took maybe 20-30 seconds. They did some topical analgesic for that, which helped only a bit. So far, the pain from that was worse than I feel today. That thing hurt! He said he needed to do that to be sure I was a candidate, basically to prove that indeed the tube was closing for reasons that Urolift could fix.
All the best in your decision... like I said, I am claustrophobic also, and at one point vowed to never have a closed MRI again. I have had several concussions, and am on the danger list if it happens again. So I certainly need to be able to have MRIs. When Metro Imaging said I would not be able to have one there, I was just about to back out of the surgery... but then I felt the urge to go pee again, only a few minutes after having gone earlier... LOL. I think it was a God thing! And then my brother also offered some good advice... he asked me "what are the alternatives?" The only alternative I see available with basically no side affects is Urolift. I decided that I (me personally) can deal with the closed MRI a time or two more in my life. (Valium is wonderful by the way!)
May you find wisdom to make your decision...
Dan
dan55298 bobbya
Posted
Sorry, Bobbya, one more thing... this stuff is obviously on my mind today, and I am sitting in a chair bored
You were asking about Flowmax... yeah, one of it's side effects is what is called "Retrograde Ejaculation".
from Wikipedia... "Retrograde ejaculation occurs when semen, which would, in most cases, be ejaculated via the urethra, is redirected to the urinary bladder. Normally, the sphincter of the bladder contracts before ejaculation forcing the semen to exit via the urethra, the path of least resistance. When the bladder sphincter does not function properly, retrograde ejaculation may occur."
and...
"Retrograde ejaculation is a common side effect of medications, such as tamsulosin, that are used to relax the muscles of the urinary tract, treating conditions such as benign prostatic hyperplasia. By relaxing the bladder sphincter muscle, the likelihood of retrograde ejaculation is increased."
+++++++++++++
If you have not had that yet, good, it might not affect you that way. It did me. It is a strange feeling by the way, not at all satisfying. I also think it has caused me to lose "staying power". One of the ways I dealt with all the issues was by taking a couple different supplements with Maca root, and H Goat Weed, etc. they seemed to help. But I will be forever grateful to the inventors of Urolift, if I can get off that stuff and the Flowmax!
Take care.
Dan
bobbya dan55298
Posted
Well Dan, if your sitting in a chair bored, I'm hear to listen, as ever since I found this forum I check it several times a day, to hear from you guys. It funny we are talking about the meds as I just had to get a refill on my tamsulosin. This one will last me until I have the procedure. Do you still have to take the tamsulosin after the surgery for a period of time ?? I am not sure if the meds have effected me like that, I know it sounds strange, but I am really not sure. Also, I did have the scope 2 visits ago, very uncomfortable test, and like you said last 20 or 30 seconds of not a good feeling. I had to go pee immediatly after that. Also on my last visit last week they did an ultrasound of the prostate to get the measurement for insurance, both tests are probably needed to satisfy insurance, and they said it had to be done before they could schedule the surgery. Rest well and I will check back in tomorrow with you tomorrow. Thanks again for all your info.
Bobby A
dan55298 mark02906
Posted
Yeah, already see a mistake in my post, meant to say that the gradient number limit was too 'low' for the machine that Metro Imaging uses. Their machine runs at 2500 Gauss/cm. The guy from the hospital explained that.
dan55298 mark02906
Posted
Well, home now...
The report time at the hospital was 9:30. Wife took me... sat by ourselves for a half hour in the prep room, then talked to the nurse, the anesthesiologist, and the doc stopped by... told him about my MRI findings. He did not know about the issue with the Open MRI because of the gradient limit. (I did not get the card with the MRI data from anyone which the Urolift website said I would receive, need to look into that.)
The surgery was scheduled for 11:00. I think they were wheeling me to the O.R. very close to that time. The whole thing took 15 minutes, wifey said that it showed 9 minutes in the waiting room when they called her number. Surgery was a "piece of cake" as someone else said. I did not remember falling asleep, remembered hearing voices the whole time, but did not remember climbing back onto the cart (stretcher) from the operating table. I had been worried about clearing my throat, because I have been getting over a cold... as I was going under, they said "OK, cough for one last time" LOL... The anesthesiologist said she would give me something to keep me from coughing during the surgery. Boys it works, let me tell you, I am still having trouble swallowing food. But I can cough now and it does not hurt!
So in the recovery room the first thing I wanted to do was pee... and actually I did about 200 milliliters right off. Included a small clot, and was bloody of course. The only pain I really have felt is this tremendous urge to pee. But after that first 200 ml, I only gave them an additional 120 ml over about 1 hour or so, maybe less. They had me sit in a chair after the first peeing, and that was really uncomfortable, because the chair had a high spot in the middle, which is such that it pushes again my back side (where the prostate is).
They gave me two different antibiotics, a pain pill, and a bladder spasm pill, not sure what those are, if someone is interested, ask, and I can look. Since I have been home, I have not had much pain other than the really strong feeling I need to go pee. I have gone a couple times since home, and passed a couple more small clots. I was not going to take the pain med, but just now did, because this urge is becoming more painful... it is on the order of having to go to the bathroom (full bladder) worse than I have ever felt it, and when I go since I have been home, it is just maybe 20 or 30 ml or so at a time.
We stopped a McDonalds on the way home, and I got a breakfast biscuit, which as I say, is difficult to eat just yet, because of the swallowing issue. Other than that, I am able to walk around just fine, feeling really pretty good! Doc orders said to stay away from strenuous exercise for a while... not sure what the means. Nurse said don't lift weights for a couple weeks...
Will let you know more as the story unfolds...
bobbya dan55298
Posted
Wow, that is AWESOME Dan, I did say a prayer this morning when I made my last post to you. Not sure if your a praying kind of guys, but I said one for you anyway, hope you didn't mind. I'm still concerned about this MRI thing, I had a hip replacement a few year backs and will need the other one done in the not so distant future, let me know if you get some answers. Please keep me posted step by step in detail, as I may be the next one on this forum having the procedure. Thanks for posting about your procedure on the day of.Rest well buddy,
Bobby A
dan55298 bobbya
Posted
LOL, Yeah, I am a praying kind of guy Bobby... very much so. (Thanks very much for your prayer!) That is why I felt like it was God talking when I got that peeing urge strategically timed the day before the surgery, right after talking to the MRI folks and getting depressed. I had thought, "God are you sure about this?" Actually that is when I called the MRI guy from the hospital and got some warm fuzzies.
Something you should do to help with your decision is to call your hip doctor... see if they know anything about MRI facilities in the area. Then also call the MRI facilities yourself. What I said when I made the phone calls was that I was a past patient. I think they feel a bit obligated to talk to you then... although, they should anyway, if you are a 'potential' patient. Interestingly, the Metro Imaging folks did look me up before they called back. When she talked to me she had my file open. Showed my brain MRIs. I just read them the specs that I posted yesterday and went from there. (be sure you find that post below) It might very well be that there are other open MRI machines which fall under those specs, where you would be OK, I just know that the Metro Imaging folks in St. Louis area do not have one.
By the way, if you have not seen it, the Urolift FAQ site is:
Not sure if this will show on the main part of the thread, so maybe I will report in on the main line of the thread with my update post... Things are going well, Praise God!
Moderator comment: I have removed the link(s) directing to site(s) unsuitable for inclusion in the forums. If users want this information please use the Private Message service to request the details.
dan55298 bobbya
Posted
bobbya dan55298
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dan55298 bobbya
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Well Bobby, my earlier post back to you is still being moderated so I guess I will type something again... Yes, I AM a praying person. Thanks so much for yours. What I said in the post that did not make it through was that you should call your hip replacement Doc's office about MRIs. Ask them for suggestions, and then I would also call around in your area to find out more details on what MRI machines are in your area.
The comment I got from Metro Imaging (that they would not be able to do an MRI on me from now on) may not be consistent for all 'open' MRI machines. The first responce I got when I talked to someone was that everything was OK because the Tesla number was low enough, but then I got the call back from Metro, and I got shook on the answer about the gradient number. Then I called facility number 3 and they were very wishy-washy about it. That is when I called facility number 4, the hospital itself, and talked to the guy who explained it to me... basically said, "yeah, Metro only has one kind of machine. We can cover you, but it would likely be in a tube style machine". He did not rule out the possibility that somewhere there is an open machine that would be under that gradient number of 1500 Gauss/cm. So it is worth checking.
So, I suggested in that post that you call all the MRI facilities around you and just tell them you are a potential customer. I called Metro and told them I was a past customer (when I left the message) and when she called back had looked up my file. Said I had two brain scans done there. It was easy to get someone knowledgeable, I just asked for an MRI technician... and if someone is not available to talk to you, ask for a call back when they are!
All the best, I will be praying for you to have wisdom in your choice!
And by the way, I went out to eat tonight! Just had to make sure I found a soft cushioned chair to sit in. LOL... it is kind of tender right under there... And... I strongly suggest taking a stool softener, right away, maybe even ahead of the surgery. That is actually more painful right now than peeing... Oh, and heard back from the doc... he said I got two hooks installed on each side.
Also said sex was OK in a week, if I am not bleeding, and forget taking flow max unless I decide I need it! Yeah! Also said I can go back on NSAIDs (Ibuprofen, etc) and fish oil.
Dan
PS... I had posted the link to the Urolift website FAQ page in the earlier post which did not make it through yet... which is where that MRI data was. That might also be why they bumped my post. Maybe they do not like links posted.
bobbya dan55298
Posted
I an happy your getting out and doing good, and thanks for all that very good information, yes I will call a couple MRI facilities as you suggested, using the numbers from your post, as I never seen it on the urolift web site. I also might set an appointment to go see my family Dr. whom I trust very much and he may have some suggestions also. I am all to familiar with having to take stool softners when I had my hip replaced. I was taking a lot of pain pills to get me through it and also before the actual surgery just to get by. I had a colonoscopy this past summer and the Dr. said to start taking metamucil on a nightly basis, so that also helps alot, to keep things regular and flowing if you know what I mean. Having the two hooks on each side seems to be the norm for this procedure. Keep healing my friend, and continue to keep in touch. Thanks for all your posts and suggestions.
Blessings,
Bobby
bobbya dan55298
Posted
Just wondering how your feeling today ?? I've had a busy day today and will be gone most of the day tomorrow. I figured I would check in and see how your feeling as I may not be able to check in tomorrow, hope your feeling better each day.
Bobby
dan55298 bobbya
Posted
Dan