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

Posted , 17 users are following.

johnny90372
johnny90372

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.

1 like, 59 replies

59 Replies

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  • david41064
    david41064 johnny90372

    Posted

    Don't be railroaded. Look at finding the size of your prostate. If over 80 do a PAE. Look up Dr at unc. Urologists r medieval. Pae is least invasive,. Others r fla and rezum.

    • derek76
      derek76 david41064

      Posted

      You can't advise him where to go as you don't know his location.  I'm guessing he is in the UK

  • kenneth1955
    kenneth1955 johnny90372

    Posted

    John  I just did another post on you  They them no.  If you have not try anything else it is not right for you to be forced into something that you don't want.  That is not right.  Get another doctor try the pills to see if they will help and they look into other procedure.  Turp is a last resort procedure.  You have not tried anything else.  Cancel the surgery and who cares if he's mad.  It's your body and your life.  I don't know if you have read up on the TURP procedure but it does cause a lot of problems but sometimes it takes a year for your body to heal.  SAY NO BEFORE IT'S TO LATE  kEN 

  • kenneth1955
    kenneth1955 johnny90372

    Posted

    John  Where are you at.  So we know  Ken
    • johnny90372
      johnny90372 kenneth1955

      Posted

      Hey Kenneth, I'm in Canada. All medical treatment is free. I went to a large medical Center Hospital. There are several doctors in urology and the one I was referred to is about 58 years old and is a director there. He also an associate university Dr. Who teaches residents during the surgeries. They assist him in order to learn. It's just that after about 20 to 30 minutes seeing him in total he said we're doing this surgery TURP and to sign the consent forms. Seems like a real whirlwind.

    • Bruno59
      Bruno59 johnny90372

      Posted

      Hello Johnny. I am in Ontario, Canada. 

      ?About year ago, I couldn't pee. My family doctor gave me Flomax, and appointment with a urologist, in 2 month wait. I was getting worse, and after seeing the urologist, it would be another 2 month to get TURP.

      I was hoping to get Holep, so I have made an appointment with a urologist in Montreal, (only one week wait), but he only did HoLEP on very large prostates, didn't accept me.

      I was 2 times in emergency, waited long hours, and didn't get any help. At the emergency, I met a guy, (patient of my urologist). He had catheter one year, had TURP done, was incontinent, and couldn't pee, and was talking  about getting another TURP. I didn't want to end up like him.

      ?I have found a doctor in Guadalajara, Mexico, flown down, and got HoLEP the next day. What a difference that was. Modern, clean hospital and doctor specializing in HoLEP.

      I also went to Buffalo, New York to get 3T MRI to check the prostate, (not available to me in Canada). 

      ?I was hoping that my family doctor in Canada would help me to coordinate my effort, but the receptionist there didn't agree with me getting a better healthcare, and obstructed any requests for help I had.

        

    • derek76
      derek76 johnny90372

      Posted

      If there are several urologist some must do different procedures. At my local hospital where I now live in Sussex the two TURP ones did not tell me that the kidney surgeon did prostate laser surgery.. I only got that info when seeing a Locom who did not know their rules:-)

       

    • kenneth1955
      kenneth1955 johnny90372

      Posted

      John  It is just to fast you have not even gotten use to the surgery.  Let along the side effects.  Your doctor is kinda pushy. Being you don't have to worry about your health care.  Cancel the whole thing and start with a new doctor one that will take his time.  Tell them you would like the lesion taking care of but you want to wait on the prostate to see if the pills will help.  There are other pill to try if these don't work.  This doctor does not even know you and he want to cut part of you out.   Please cancel both  Ken  

    • derek76
      derek76 kenneth1955

      Posted

      Remember in Canada as in the UK the doctors are salaried and not paid per patient so they have no financial incentive in getting John on the table. Here in the UK they would rather get the long waiting lists down by offering drugs instead of surgery. Also drugs do not come off the hospitals budget as they are prescribed  by ones GP.

      I waited about six months for my last laser surgery.

    • kenneth1955
      kenneth1955 derek76

      Posted

      He want to use him for training.  I wonder why the other guy canceled Could be the same reason....Ken
  • derek76
    derek76 johnny90372

    Posted

    Beware of Tamsulosin if you want to be a father. It reduces sperm output and can cause RE amongst many other side effects. It can cause eye problems including floppy iris syndrome that would make any future cataract surgery difficult.

    See BNF list of side effects: 

    Angioedema; asthenia; blurred vision; depression; dizziness; drowsiness; dry mouth; erectile disorders; gastro-intestinal disturbances; headache; hypersensitivity reactions; hypotension (notably postural hypotension); intra-operative floppy iris syndrome; oedema; palpitations; priapism; pruritus; rash; rhinitis; syncope; tachycardia.

    Cataract surgery (risk of intra-operative floppy iris syndrome); concomitant antihypertensives (reduced dosage and specialist supervision may be required); elderly

    • uncklefester
      uncklefester johnny90372

      Posted

      My prostate was 125 cc when I started finasteride. I don't know how big it is now but my date time flow us about 20ml/sec

    • Bruno59
      Bruno59 johnny90372

      Posted

      Hello Johnny. Here is a list of procedures for treating prostate (BPH)

      BPH treatment methods

      HoLEP

      ThuLEP

      Simple prostatectomy enucleation

      Aquablation

      Turp

      ejaculation preserving TURP

      Bipolar TURP

      Button TURP

      FLA Focal laser ablation

      (PVP). Photoselective vaporization of the prostate green light laser

      ISV embolization of varicoceles

      Resum

      Cryoablation

      Dr Song 3D method

      iTind

      Radical prostatectomy

      Holap

      PAE

      (TUNA) Transurethral needle ablation

      (TUIP) Transurethral Incision of the Prostate

      (TUMT). Transurethral microwave thermotherapy

      UroLift

       

    • johnny90372
      johnny90372 Bruno59

      Posted

      Great! Thank you so much for the list. I really gives me a total overview.
    • derek76
      derek76 johnny90372

      Posted

      So many choices but how many are easily available to you in Canada.
    • johnny90372
      johnny90372 derek76

      Posted

      In Canada you don't have many choices. You're lucky to get a Specialist. And they're very rushed in the hospital. Some most of them probably just do Turp.

      I am a bit confused because the doctor said it's likely you won't have retro ejaculation or any problems from the surgery. I want to try to manage the BPH without surgery for as long as I can. Does that sound valid? And is retro ejaculation given after all TURP surgeries?

    • johnny90372
      johnny90372

      Posted

      What I mean to say is in most statistics I'm reading  about TURP retro ejaculation happens about 90% of the time. It's virtually impossible to work on a prostate median lobe without creating retro ejaculation?

    • kenneth1955
      kenneth1955 johnny90372

      Posted

      John you have a 4 % chance of not having retro.  That is not good odds.  He is telling you that because he want you to have the surgery but ask yourself why did the other guy change his mind.  It may be the same reason.  They has to be another doctor you can talk to not in that hospital.  Even if it is your own piece of mind.  Also lets say you have the surgery and you get retro and all the other problem.  There is nothing you ca n do.  Your done.  Ken
    • kenneth1955
      kenneth1955 johnny90372

      Posted

      I am afraid when he get in there he is going to to the turp, mess up your nerves, cut out the median lobe and do some type of bladder neck incision.  3 strike your out.  That is when your problem will begin.  Most men that have a TURP they are at there last resort.  You have not even try anything else.  You said you have only been doing the BPH for a year.  Most men that go for surgery have been deal with the problem for 2 or 3 years and they have tried other things first.  God help you  Ken     
    • derek76
      derek76 johnny90372

      Posted

      You need to ask him to explain why no retro. If he keeps well away from the bladder neck you should be OK. We don't know which parts of your prostate are the problem.

    • jimjames
      jimjames johnny90372

      Posted

      Even if a surgeon performs an EP (ejaculation preserving) TURP, there is still chance you will get retro. That said, very few surgeons perform this procedure, so I have no idea where he gets the idea that you have nothing to worry about. Either there was some sort of miscommunication where he meant you would still have orgasms  which is true except they are dry. Either that or he's frankly full of it. When I asked my doc what were the odds of retro if he did TURP, his answer was "100% if I do it right". It's simply not the right procedure if retro is an issue and if someone tells you otherwise, ask them to show you a paper they published because I'm sure the urology world would love to hear about it!

      Jim

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