Urologist insists I get a TURB for BPH-- Should I decline for now?

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Im 58 and saw urologist at a big hospital after a cystoscopy he insists and scheduled  a TURP for me.

I haven't tried the medication therapy yet. And want to decline theTURP even though my BPH symptoms are fairly bad. This procedure seems it comes with a lot of problems including erectile dysfunction, retro grade ejaculation, and all the horrible post operative recovery one reads about. When I told him I didn't want this procedure he got angry and said I could have big complications including kidney failure. Can anyone give me any advice, please.

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  • Posted

    I had a similar experience except my Urologist wanted to do Green Light laser rather than the TURP.  Kinda the same basic idea only the laser has a shorter recovery time.  The Urologist didn't even do a cystoscopy and scheduled me for surgery 3 weeks later.  In the meantime they had me go to a medical supply place in Boise and get about a months supply of one-time use catheters.  They were not hydrophilic; I was not familiar with CIC (clean intermittant catheterization) at all and was afraid to enter into this.  I could still get a small amount of urine out naturally but was experiencing overflow incontinence especially at night and was having to wear depends.  In the few weeks before my scheduled surgery I overcame my squeemishness about doing this.  It felt so good to fully empty my bladder that I quickly got used to it.  When it was time for my pre-op appointment one week before surgery, I had decided to turn it down and just keep catheterizing.  I went on medicare a few weeks later and was able to get the catheters for nearly free through the mail and started using hydrophilic ones that are sterile, reduce the chance of a urinary infection; I was already reducing that chance by doing cic;  I still have not done any drugs except saw pamento which I hardly mention because I don't think its doing much for me.  But I have to cath at least 4 times a day but its under my control.  The green light laser could very well have worked for me but I definitely felt they were rushing me in.  I have to say that the Urologist may have done that because when I first went there I was in complete retention.  They wanted to do a bladder scan and I lived 50 miles away; by the time I got there and had drank the amount of water they wanted me to drink before the ultrasound, I couldn't even get enough out for a sample.  I had to cath to get them a sample.  Anyway, read the threads on here about self-catherization under BPH.  A lot of good information.  Self-cathing gives you more time to investigate your options before entering into something you'll regret.

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  • Posted

    I feel one should get such procedures done as a last resort. They have medication to shrink Prostate which could be an option to start with.
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  • Posted

    Hi Johnny, you are still young , CIC is fine within your  rational and optimal treatment selection.  After one year of CIC I selected FLA .  flying to Houston  for April  3rd. procedure.   First of all  make MR scan  to see in details what is your problem  inside. Then consult  with real  expert  and decide  for less invasive method.  PAE,  Urolift,  REZUM or FLA.  I have big median lobe  with  IPP ( protruding to bladder )  so for me is the Best FLA.  if you need more info just PM me, Stan      
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  • Posted

    At your age, I had a procedure TUNA (needle ablation) that was less invasive than TURP.  It helped a little on the BPH (my symptoms were moderate compared to many on these forums).  After 10 years, I was needed another procedure (prostate growth?).  Last year, I had a Urolift.  On the other hand, a friend -mid-60's - had TURP and he is doing well.  Your doctor is right about kidney complications.  The last 7 years of my father's life, he had to have kidney dialysis 3 days a week.  You don't want to stress your kidney's that you have no option but dialysis (or transplant).  You are going to have to do something.  Keep reading.  The people who have replied so far have given you a lot to think consider.  For some like Iqbal, medicine might help.  For me, tamsulosin (generic Flomax) did little for the BPH, gave me retrograde ejaculation and reduced my ability to exercise (interfered with my blood pressure medicine?)

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  • Posted

    Oh, absolutely decline for now. There are many other less invasive possibilities (Meds, PAE, Urolift, Rezum, etc.) that you should research and then make a well informed decision. This forum can be a great help in doing that research. First thing for all of us to know is what are your symptoms? How long have you had them? Do you know the size of your prostate?

    Rich

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  • Posted

    Johnny,

    I  just answered your question in part over in the self catherization thread where you posted. But the answer is clearly "yes", you should decline until you feel both educated and comfortable with the decision, neither of which you seem to be.

    I also would consider getting another urologist who is using scare tactics with you, and probably only offers TURP. You should know that there are other procedures out there, but not every urologist does them, and urologists tend to push only procedures they do. In your case, it's TURP. 

    Part of the decision process should be a complete workup including a DRE, bloodwork, bladder/kidney ultrasound and urodynamic testing. The bladder/kidney ultrasound  in conjuntion with bloodwork will show you right away if you have any kidney issues. You should also google "IPSS Score" and take the test to see where you fit in with others in terms of BPH.

    Your urologist does have a point, however, in that BPH can eventually lead to kidney damage, but again, bloodwork and a bladder/kidney ultrasound will show you if that has started or not.

    You should also know that there is a non surgical alternative to protect both bladder and kidneys called self catherization. It will buy you time until you make a surgical decision or it can turn into a longer term solution as it did with me. And going back to what your urologist suggested -- it will prevent "big complications including kidney failure". Unfortunately many urologists don't support or recommend self cathing much in part since there's no money in it for them.

    Jim

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  • Posted

    I think it depends on your symptoms. My uro wanted to do TURP. He  still had the scope inside me, he said you need TURP pulled scope out and walked out of the room. I made an appointment for consoltation. I asked him how exactly was he going to remove prostate tissue. He was very vague, saying, laser, hot wire, etc. I told him I'll try drugs first. I was put on firnasteride and found another uro. 

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    • Posted

      My symptoms, are the typical B pH symptoms. Frequent urination, not completely emptying my bladder, sometimes weak stream, getting up several times from sleep.

      I haven't tried any meds yet. Only saw palmetto. I have prescriptions for Tamoslin and Avodaut (spelling) I haven't tried them yet. 

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    • Posted

      Firnasteride has worked wonders for me. I think it made getting erection more difficult though. I did read a recent study that said it doesn't affect erections though

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    • Posted

      You need to try the meds first before you do any surgery.  That doctor should know that.  He is trying to make back the money from the other canceled surgery..Ken
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    • Posted

      What medication is better and faster working.tamsulosin or dutasteride?

      I was going to start trying tamsulosin. Do You know how fast I would start to see reduction in BP H symptoms?

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    • Posted

      Tamsulosin will work relatively quickly, in a few days, but many men, including myself, have had difficult side effects. It works by relaxing the smooth muscles that are along the urethra. Dutasteride is a different kind of drug. If it works, it will shrink the size of the prostate, but it can take as long as six months to see results.

       

      I switched from Tamsulosin to daily Cialis, which works in a similar way, and had less trouble with side effects.

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    • Posted

      Hi, how long did it take for got to work? Like I said I haven't tried any medications whatsoever. So going straight into it TURP surgery maybe seems like jumping the gun?

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    • Posted

      Firnasteride took about 6 months to see results. I started raking it I Feb 3016 July that summer I said screw it I'm gonna have HOLEP and get my life. By the time got in to see a uro that was experienced in HOLEP my.symptoms had improved so much I postponed. I'd have FLA if push came to shove. Right hoping and praying for magic bullet that doesn't involve cutting burning or any thing remotely invasive. Kind of like an injection into the prostate that shrinks it. Fat chance, right? A fella can dream can't he ? LOL

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    • Posted

      Absolutely jumping the gun. Evaluate all options. From what you've posted, I think trying either Tamsulosin or daily Cialis would be worth a try. What did your uro doc say about the meds?

       

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