Urolift Procedure - February 2017

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.

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