Watchful Waiting

WELL SAID TOM   My doctor said the same thing.  TURP is the last resort   Ken

Hi Jim,

There are good stories around what a wonderful outcome for you. What was prostate size?

It seems investigating alternatives is prudent but on the other hand it seems that a skillfull Uro can deliver a TURP such as yours - how good for you.

I have read that minority of TURP do not result in RE with all other aspects healing right as well great that you are one of those stats.

As others posts suggest I will look at all the options but TURPS can work although I'm not going to rush into it.

Top  Please look into anything you are going to try.  You will get Retro with a TURP  Jim was very lucky because he had a good doctor. But there is only a 3 to 4% that you will not get retro.  There are good and there are bad story's It is up to you to pick what you can deal with.  Jim had good results  And then you look at Super  He ended up with all the problems.  And sex is not in his life anymore.  Can you deal with more problems.  It is a hard decision There are to many other procedure you can look into   Good luck Ken 

I agree with you Ken. He needs to look into TURP to the level that he understands what, why and how the Retro E happens. It is because of the slicing of the urethra tissue as they clean you out. The Ejaculatory Duct opening are sliced across as they pull the blades down and out of the Urethra. This make them collapse in some cases and in others, the tissue is closed as the area heals that way. You are correct it is only a low percentage of no side effects and the no retro issues is one of those. 

PAE on the other hand is a shot in the dark and is a random effort that can not target or direct the atrophy results of the gland tissue. The Gland tissue atrophy will not effect all the areas of the prostate the same. If he had a large median lobe, he needs targeted tissue removed from the inside of the lobe to reform and reshape the prostate so it does not protrude into his bladder. TRUP does not do that. TRUP opens the passage way (urethra). 

As you have stated, the answers are all out there for us to ask, find and review. How and Why does it cause Retro so much?  I would want to know that reason and not from a doctor who sales TRUP. How is the procedure actually done, What is the equipment used? What is the healing process? How controlled and focused is the procedure? 

These are far better things to consider than some Urologist telling you "don't worry, it is the gold standard and  FDA approved". It has been done ten or even Hundreds of thousands of time to men".

Yet I have never heard of one Uro getting a TRUP procedure for them. Maybe in the old days 25 years ago when there was no alternative. But not now. 

I think each man should know every little thing about a procedure and the working of the prostate components before you let them mess with your goodies. If you know the componets of your gland you can ask a doctor how they go about a procedure and NOT cause issues. If a man does this, he will compare and choose the correct procedure. If not, he better pray the doctor does not hide or stretch the truth. Because it seems every Urologist had that college class that taught them how to look at you shrug and say "sorry, it just happens sometimes, and besides you will be fine not ejaculating during your orgasm and also keep in mind, your wife may like it a lot better".  

Now this is said if they don't give you erectile dysfunction with nerve damage or seminal vesicle destruction. "Oh well, we tried, sorry".

This is the fearful fact we are ALL faced with in this horrible condition when looking for relief. Men should understand this is truly "buyer beware" and just taking a doctors word or being lazy about the researching one should do  will get in a life changing situation. 

I am sure they teach them (urologist) that BPH is not terminal, and they say we are mainly aged men so if they can help us urinate then we are fine. I have had them claim, that this should be the target for all BPH patients by Urology.  They say we will get by and don't need all the sexual functions of younger men anyway. I actually had a Urologist tell me my child bearing years were over. I should not be concerned with retro grade ejaculation as it is not an issue.  I hope this makes some men think and take action to protect themselves. I feel that all these procedures are logical in their applications and one should be able to understand why and how the percentages of success and side effects happen in learning the facts about each one.

You do not have to be a doctor to understand the practical application of Urolift and it's theory or PAE or TRUP or FLA of any of the several procedures they want to sell you. You can learn the practicality of the procedures and ask very pointed direct questions of several providers. 

I don’t know the size.  I chose TURP for the long lasting results.  I was prepared for RE.  I just wanted to be rid of the urgency and extremely low flow issues. I would have been satisfied even with RE.  I would not have been satisfied with incontinence.  I know some TURP’s cause that.  My uro did not feel that was a significant risk in my case.  I looked at other options, and was hoping for Urolift, but I was not a good candidate because of the median lobe.  To staple the median lobe risks puncturing the colon.

John that is very true.  Doctors to not consider the male ejaculation a sexual function.  We are giving that just to have kids.  I think that is not fare.  The ejaculation goes with the orgasm.  Besides why should we have to pick one over the other.  Men need to be aware of all the procedure because most doctor do not want to learn any of the new ones.  TURP is what they sell.  They go in and just cut away.  They don't care if you end up wearing a diaper or if you never get a erection let alone retro.  There main goal is to get you to pee. If anything else happen   They just say.  I don't know what happen.  And 2 or 3 month's down the line they talk you into having another TURP.  There are so many different procedure that have work for many men on here.  You need to seat down and make a list of the pros and cons of the procedure that you are looking at.  Ask question either your doctor a friend or on a forum.   And if your doctor blows it off.  Fine another doctor.  This week there have been to many men that were taking for a ride now they have to suffer with the problem.  I hope all get better soon and may god help us all  Ken 

Jim  I wish you a lot of luck with yours.  Do you know that you may have to have another one in a few years.  The prostate still grows.  Faster in some men. Life throws us a lot of curves when we get older.  Not saying that it has helped men but over the last few week I have read about men having 2 turps and GL  because the first one did not do the job.  Or there was a guy that had to have 2 Turps in 6 month's because the doctor did not do the first one right so he had to go in and clean it up.  There are also men that after a turp they can never have sex again because the nerves were damaged.  I can go on and on.  But every man has to pick what he can deal with.  Some men just want it over and they are not concerned about anything else.  Good health to you and may god be with you..Ken   PS.  If Turp was so great why are we coming up with better procedures.....???????   

J, 

You stated that PAE is a "random effort that cannot target or direct that atrophy results...". That's true, but it works for most who have it done, and it's the most effective treatment with the least trauma to the patient. I had mine done in August, and I am now off Flowmax and sleeping better at night. I may have a second PAE next year depending on how much more improvement I experience. Then, if I am still not satisfied, I will consider some form of laser treatment. 

I have studied all of the BPH procedures in great detail, and after two years of research decided to move forward with the PAE. No bleeding, no catheter, only slight post operative discomfort, went of the Flowmax after 5 weeks. I was prepared for NO improvement because of a median lobe extension and prior radiation for prostate cancer (successful). I am pleased that the PAE has worked as well as it has so far. The doctor told me that it would take six months before the full extent of the treatment is known. So, far I am four months past surgery and I am very pleased. 

Tom

Tom I am very happy that your happy that is all that matters.  But we have had some men that have had the RAZUM that have not been that happen because they ended up with retro ejaculation which the doctor told them that it would not happen.  The one man said after 10 days he had sex because he felt well enough.  He had very little sperm with some blood.  He waited after a month and there was nothing and the orgasm was not the same.  A lot of men are trying this because they want to keep there ejaculation.  The only way to be sure of keeping it is to only have the right side done this way the left is not distroyed by the steam.  We have had 2 men on here in there early 50 had it done and it worked fine for them.  You should be able to have any procedure you want the way you want it done.  It is your body and you are the one that will have to deal with any side effects.  A 58 I did not want retro that is way I had the UROLIFT done.  All fine for almost 3 years.  We cannot pic a procedure for anyone we have to do it for ourselves.  What ever make us happy and the doctor should care about his patients concerns not just over look them.  Take care   Ken

Tom thank you for the update that is wonderful I'm glad your procedure worked for you to the degree that you say it did and I hope your second one gives you even more relief I wish you the best of luck we all are fighting the same thing to try to find a way to get better. Good luck. John

Ken,

I had a PAE, not REZUM. The PAE procedure was very easy and comfortable. The only issue was that while I was in the recovery area of the hospital I had to lie on my back for 6 hours and my bladder kept filling up with urine until I requested a catheter.

I would recommend a PAE as a first procedure for anyone, as it is easy with few side effects, can be repeated, and does not preclude any other procedure in the future. Based on my research, all of the BPH procedures have, in the long run, similar effectiveness curing the BPH, the only real difference is in the after effects and recovery time. So, PAE first, then Urolift, then laser or REZUM (this includes FLA and HIFU) then TURP. After effects would include hospitalization, blood loss, days of Foley Catheter, retro ejaculation, blood in urine and sperm, long term changes in sexual function. Other considerations would be out of pocket cost and travel expenses to the operation site. My PAE was covered under my insurance and I only had to travel 90 miles with an overnight stay in a nice hotel. 

Tom

Tom

Tom so sorry I was talking with so many guys I got you messed up.  Do you end up with retro. or less semen in the ejaculation or have you not tried it yet.  There have been some men on here that had Par and try sex after a few weeks blood in semen and they after a month nothing.  I hope all worked well for you and you are happy with the out come   Ken

Tom, what insurance did you have that paid for PAE ? Thanks. Hank

Ken,

PAE does not cause retro or blood in semen since the prostate is not touched by the procedure - the arteries supplying blood are blocked. The last time I had blood in semen was after a 12 core prostate biopsy. Had blood for two months - Uro must have hit an artery. 

Hank,

I have Kaiser. They did the PAE in Oakland (California). It's the only Kaiser in the state that does this, so I was fully covered, except for a $250 copay, which is what I pay for a simple MRI. With Kaiser, you can go to any specialist anywhere in their system for any procedure, and just pay one copay. I am on their Medicare Advantage plan. I thought the team and equipment was first class. I was fully awake, and completely pain free and comfortable during the operation. I got to the hospital at 7am and was in the recovery area by 10:30am. As I said in a previous post, the only discomfort was not being able to walk to the bathroom to urinate for hours. If you don't lie down you can bleed at the puncture site - they go in through an artery in the fold where your thigh meets your torso. It's a very tiny puncture point. I had something similar many years ago when I had a cardiac stent put in, but that puncture hole was larger, and they put in a plug to prevent bleeding. But I still had to lie down for hours before I could finally stand up and go to the bathroom. In the late afternoon my wife picked me up and we stopped at a restaurant, then drove home. Compare that to a TURP!

Tom I only repeated what I read.  The man said that he had a ejaculation about 10 days after had very little semen and some blood and when he tried it again in two week he was dry nothing came out.  So I don't know what happen.  When I was 47 I had a 12 needle biopsy also.  A lot of blood in the first 2 times  I did not make it out of the building.  It was going on three weeks.  The orgasm hurt so bad but I guess it felt good to  Have a great day  Ken  

Thank Tom. Hank