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
Dan
mark02906 dan55298
Posted
Dan, thanks for helping all those who read your posts. With all the options for treating BPH, it's better to have more information. I wish you continued success in your recovery.
I have the one-year checkup with my urologist next month. If there is anything valuable from that appointment, I will post it. On average, I get up once a night. Stream seems stronger most of the time. I am not concerned about it to check my diet or fluid intake.
joe82842 mark02906
Posted
mark02906 joe82842
Posted
I have uroflow testing and bladder ultrasound in 2 days (about a year after my Urolift procedure). For those who haven't had this, you drink a quart (or liter if you're metric) of water 1 hour before the test. You pee in a bucket that's on a scale connected to a computer that takes measurements of the speed and amount of urination. The bladder ultrasound (note: they keep the gel between the device and your skin in the freezer) measures whether you have completely emptied your bladder.
In my urologist office, they also take blood for a PSA reading. Yes, it's controversial.
Finally, in a couple of weeks, the urologist arrives in the room (heated to slightly above a freezer. Oh, yes you are allowed to go home after the test) carrying a laptop computer. Here's the important part - wait until he/she is finished talking and don't say anything. This encourages them to look up from the computer and verify that the person is the same one whose file they are looking at. (Slight exaggeration)
I'll post anything on the results that I think will help those considering this or other treatments.
mark02906
Posted
Since you are the one who asked for the update, I will go into a little more detail.
My doctor has checked the UroFlow twice - at 6 months and 14 months - with the addition of a bladder ultrasound. The conclusion is that I am not retaining any urine. Also, my nocturia - getting up at night - is probably as good as it can be. I average about 1 time a night. Some nights 0, some nights 3 depending on whether I drink or what I drink.
At this checkup, he added a test called a UroCuff. Basically, they put a pressure cuff (like what you get when they do a blood pressure test) around your penis. While you pee in the bucket (UroFlow), the cuff inflates and deflates a couple of times. The urologist says this gives him more information how the prostate is open. You probably can google the UroCuff test for more info.
I am no longer keeping pads (Depends Guard) in my car/gym bag in case I need it. I fly occasionally on business and I do keep a couple in my carryon. I am not too concerned about getting to a bathroom anymore.
I rode a bike for about an hour today. I had no soreness or urgency to empty my bladder.
Will this be my last BPH procedure? Who knows. I hope so. Will this work for everybody? Probably not. I consider myself lucky. The first procedure I had 12 years ago worked at first. But, I guess my prostate kept growing. The optimum treatment for BPH (surgery/medicine) is down the road. I hope my experience will help the medical community find better treatment for our sons and grandsons.
Hope you find a good solution.
dan55298 mark02906
Posted
Hey Mark, I replied to Bobby below with some comments about my two week follow up visit today. Head several questions he answered. One thing to add, they gave me an emptying test today like you were going to get, no flow test though. I only had, I think she said, a CC left in me afterward. They did not make me drink a liter/quart though.
I do have one other question to those at large who have had the Urolift... Do you remember the Seinfeld episode where some gal happens to catch a glimpse of George naked? He had just gotten out of the pool. Later she was commenting to her friends about George's shortcomings, and he said Hey! That's pool "shrinkage"... Has anyone else noticed that since the surgery? I seem to have that pretty much continuously since the surgery... (except during an erection thank goodness)... just wonder if that is common, forgot to ask the doc about it...
Dan
mark02906 dan55298
Posted
I haven't noticed any specific difference in size since the Urolift. As I approach my 70's, I have noticed that erections are not as strong or long lasting. But, I think that's an age issue, not specifically related to the choice of surgery. Others may have a different opinion.
It's a coincidence you mentioned that Seinfeld episode. I started another page this week '"I want you to put this UroCuff around your penis"'. I mentioned that I was having a UroFlow test (then bladder ultrasound to make sure there was nothing left in the bladder). They surprised me with a UroCuff test. I had to wrap the cuff around the penis while the 20-something technician was in the room. One of the guys who commented on my blog mentioned that Seinfeld episode too.
dan55298 mark02906
Posted
mark02906
Posted
This will be my final status report on my Feb 2017 Urolift procedure (Others who are using this for information, please continue if you need to).
To keep this brief, my 1-year tests have been positive - a key one for me is completely emptying my bladder (My father suffered from kidney disease). My nocturia is acceptable - about 1 time a night with some nights at 0 and some at as much as 3. The stream is strong. I don't remember it being this strong after the needle ablation 12 years ago (TUNA).
Will this procedure be my last? I hope so. As the optimum procedure for one man may not work with others, the best BPH procedure is yet to be developed (whether surgical or medicine).
For those finding their own way through BPH, I wish you the best. For those who have/will help me, thank you for sharing your stories and suggestions.
bobbya mark02906
Posted
Mark,
Thanks for starting this post, you have helped me and many others I'm sure. Continue with good success and all good wishes.
A quick report on me, I have been taking the low dose Cialias for about 5 days now, really nothing to report any changes. I still look for a bathroom everywhere I go and get up several times a night to go. My Dr. and a friend that is on the same med said it could take up to 2 weeks before I notice any changes. I will continue to look and post anything on this forum.
All good wishes,
Bobby
Thanks so much,
Bobby
mark02906 bobbya
Posted
I hope the Cialis helps. Keeping reading other people's posts from time to time. Their stories helped me ask the right questions.
dan55298 bobbya
Posted
Hey Bobby! Yeah I finally checked back in... I was at a conference and have another next week so I have been busy. Good to hear that you are finally trying out the Cialis... I will be curious, might be something I would try some down the road as the procedure results become less effective.
As far as a report on me, I am a bit disappointed, not a big deal, but my flow never has gotten much better since that follow up appointment with the doc... he said it would possibly continue to improve, but really it has not. I still have the shrinkage issue to a point, but it does not affect an erection. I am still using Viagra as needed for that, but have not needed to go back to Flomax. However, I have been taking one of the "prostate support" over the counter supplements (saw palmetto, etc) one a day at night. So all in all, it is MUCH better than before the surgery, but I never have gotten back that easy flow from several years back. The best part of it is that I do not have to worry about having to find a bathroom as soon as I have an urge... today at work, I had an urge to go for probably 45 minutes before I got up and went to the bathroom... still had no problem with flow locking up (like I had been having before the surgery) I think the reason I just don't have all that much pressure has to do with my bladder. The doc said that is common, that old guys, even though they might have a good opening through the prostate, still don't have that much pressure because their bladder is just not as "springy" as it once was, sort of stretched too much. He did mention that before the surgery to give me a warning that Urolift might not be the panacea we all were hoping for. Would I do it again? OH Yeah, I would... I had been getting more and more worried about traveling, you know, either in a car, or on a plane, you just don't always have access to a potty, or whatever... and that does not worry me now anywhere nearly as much. Wife went with me to the conference last week, and we flew to Fort Worth... hour and a half flight from home, and never had to run back to the potti in the back of the plane, thank the Lord... Anyway, just wanted to check in and give an update... Hope the Cialis is working by now! It should at least be making weekends more exciting! LOL
All the best...
Dan
dan55298
Posted
Hey Bobby, Thought of one more thing you might find interesting... because I was always very careful about drinking too much fluid before bed, before the surgery, I would not get up between say midnight and 6 am, however, if I did not get up at 6:00 am for sure, I would be in trouble and locked up, standing there waiting for maybe 5 minutes to finish peeing. Now I have gone as much as 8 hours over night, and do usually take a drink (not a lot, but 3 or 4 ounces) before bed. Much better situation than before. And I am not gloating, I just want to let you know for me at least that "result" of the surgery is real for me. Take care!
Dan
dan55298
Posted
bobbya dan55298
Posted
HI Dan,
Sorry it took so long to get back to you, I have been very busy this past week. Thanks for keeping me very much informed on your progress or lack of sort of speak. Sorry your kinda disappointed on the outcome but glad you said you would do it again, that is encouraging for those of us in the need to know category, like me. I am very much interested in your weekly keep in touch report, and I thank your for that. I have been on the low dose Cialis for I think 19 days now, there is no change as of yet. Its such a low dose that there is no issues with walking around with an erection all day LOL, that was one of my concerns when the Dr. wanted me to try it for a while. I will continue using it, as I have a 90 day supply. I would think after that supply is getting low I would evaluate if it helping or not, before I order another 90 script. I am continuing to take the Tamsulosin as per the Dr. instructions. What kind of side effect did you have while you were on that med if you don't mind me asking. Not sure what I should be looking for as far as side effects. However, did you read a post a week or so from Rudy Boy replying to Mark ?? If I read his post correctly he mentioned about a side effect being low ejaculation and he told his Dr. and his Dr. took him off that and put him on something else called Alfusosin 10mg once daily instead of Tamsulosin. I think I may be experiencing that in the bedroom. Maybe he will read this post and chime in to let us know if the new med has improved that. So, I would be interested to learn what kind of side effect you had on the Tamsulosin. I have a Dr. appointment this Thursday and will ask my Dr. about switching. I don't have issues with not being able to Pee,( as you mentioned being in trouble) standing there for 5 minutes waiting to go. My problem is I pee way way to often !! I will be traveling in an RV in a few weeks, I am very concerned about the travel as when your pulling an RV you can't stop at a MCDonald or somewhere quick to pull off the freeway to go. I have to look for rest areas and some times that can be a challenge finding one. Anyways, I will look forward to hearing back from you in regards to my questions. Thanks for keeping in touch my friend and I am glad your doing good.
Best Regards,
Bobby
mark02906 bobbya
Posted
Sorry to jump into your talk with Dan, but I had to comment about Tamsulosin. I took one per day for some months before my surgery. Most people can tolerate it without retrograde ejaculation (RE) - orgasm without anything coming out the penis or circulatory problems. With me besides the RE, tamsulosin took away my physical endurance - couldn't do much at the gym or do recreational running. Maybe it's my body, maybe it's the combination with blood pressure medicine (which I reduced when taking tamsulosin). For me (again it works for some others), it didn't reduce the number of nightly bathroom visits. After the surgery, I stopped it and never looked back.
Regarding your trip, I started wearing Depends Guards on long trips (car and plane) after the surgery. I found that I didn't need them, but I thought that I would. For me, it was peace of mind.
You'll find the right path for you. Keep on tryin'. Enjoy your trip.
dan55298 mark02906
Posted
Hey Mark and Bobby... yeah, for me the flow max issue was Retrograde Ejaculation, along with low if any ejaculate, along with always needing Viagra... if you have not had retrograde ejaculation, that is great. It is a really "uncomfortable" feeling. I tried several other prescription meds and pretty much all of them caused some form of that... at the end I was also taking horny goat weed (over the counter or Amazon), or some other mix of it (with maca root, tribulus, arginine, etc, I tried several of combinations of them) (also used something called Testojack which I liked). These did indeed help somewhat with the ejaculation "amount". Pretty sure they helped with the RE also. RE sort of feels like ejaculation, but just nothing comes out, and it almost feels like it is going backwards, which I guess in reality it is. Not fun... Well, the good news is, since the surgery, I do not need the horny goat weed to increase the ejaculation... there is plenty. LOL... So, that means the RE and low ejaculate amount issue is reversible when you dump flowmax. Also, I wonder now if the Horny Goat Weed (and stuff), might have confounded the flow problem, maybe made is harder to get decent flow that is...
A suggestion for your trip might be to grab a cheap porta potti, if the RV does not have a bathroom... put it in the back of the RV for an emergency? By the way, I am still taking one of the "prostate support" over the counter meds, which is something like Beta Prostate... same stuff. I just felt like a little help might still be in order... I prolly should dump that at some point also!
You know Mark, you might be right about Flomax just depleting you... I am thinking I have more energy after work since the surgery (and dumping flowmax) I had been coming home and flopping in the recliner for quite a while... not quite that same burn out now?
Take care guys!
Dan