What if Urolift does not work?

Posted , 11 users are following.

I had the Urolift March 25 and my flow is a little worse and I have an unpleasant sensation in the Prostate area after almost 4 months now.

FYI, I have had a frequent urination problem most of my life and at 42 I had Urologist tell me to be thankful I had good kidneys. Now in my late 70's I went back to a Urologist thinking maybe my enlarged prostate might be making the problem worse. I explained that my flow was fine for me but the urgency and frequency seemed to be getting worse. I tried just about every medicine including Flomax and Alfusion with various side effects. The only thing that has helped is Mybetriq for an Over-Active-Bladder but it stopped working after six months. My doctor doubled the dosage but it caused serious side effects.

My last visit to my Urologist suggested that he could remove the clips and do a partial TURP. My first thought is that if the Urolift failed then will the partial TURP work, and can he do it to prevent the retro ejaculation problem.

I go back for another visit in August to discuss options, but in the meantime I am researching and reading everything I can about medicines and procedures---including this forum. I did not like Flomax for the retro ejaculation side effect but recently I read about taking the medicine every other day would eliminate the retro problem and still work, so I am trying that now.

Cystoscopy's and Bladder Pressure Test I have had have revealed my Bladder has been and is working hard; so my Urologist said there is some blockage and releaving that would allow my bladder to relax and heal and I would get better. Now that the Urolift has failed I now do not trust my doctor that a TURP will work. I feel my flow is OK for me and so I think I will only have the TURP or other procedure done only after I AM HAVING TO URINATE THROUGH A CATHETER.

Any feedback might be helpful but I wish Urologist's would read these and provide some feedback.

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  • Posted

    Hi Jim,

    My Urolift did not work either. My urologist & I "briefly" discussed removing the clips, but I said no thanks. They stay in until something dislodges them and they have to get removed.

    Have you tried Doxozosin? I'm on the standard 2mg and it's working satisfactorily. Not perfect, but given all the alternatives, I'm sticking with this med - and there are NO retro issues. My brother, 7 years younger, is on the same and also does fine. Interesting that my uro. had not "thought about" Doxososin until I told him that my provider gave me a starter dosage and that I was pleased at getting improvement. Yet the uro. STILL brings up the TURP.

    I'm 72 and going to put up with any minor problems rather than face more prodding, surgery and the risk of other sides effects which cannot be predicted. If I got to pee a little more frequently or not totally empty, so what. For now I'm pleased with my so-called equilibrium.

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    • Posted

      Thanks I think Doxozosin will give me side effects like Alfusion did wtih my Blood Pressure, however, I will ask my doctor about this drug. I will be asking my doctor about removing clips in the urethra but I am afraid the Anchor left in the prostate might still leave me with the uncomfortable feeling I now have. I am now trying Flomax again but only every other day to hopefully prevent retro but still help.

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  • Posted

    Jim,

    The Urolift moves the tissues but a TURP removes tissue and it will work. If I may borrow a popular phrase and change it a bit, a lot of men here have TDS - Turp Derangement Syndrome. They seem to have a huge fear of this operation. I had one a few months ago. Very easy, pain free, out of hospital in 4.5 hours, Foley catheter in for 3 days only, no pain meds needed, recovery quick and easy. There are ways of doing the TURP that avoid the ejaculatory ducts. Tissue samples sent to lab to check for cancer. A modern bipolar TURP or plasma button TURP are NOT the same as the older monopolar style TURP. After reading about what has happened to guys who have gone through the Urolift or Rezum or other similar treatments, I decided that the bipolar TURP was the easiest and most effective way to be able to pee again.

    You have got to get your life back and stop worrying about whether you can pee or not.

    Tom

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    • Posted

      Thanks for the reply and info on TURP. When I get desperate I might find someone that can preform one of the TURP procedures that has a good chance of not causing retro.

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  • Posted

    I'm not sure you have BPH. If your flow is OK and urgency is your problem you probably have overactive bladder. The fact that Myrbetriq helped seems to point to that.

    There are other overactive bladder meds and you should try them. If one works, even temporarily that would confirm my suspicion. In fact, Botox is the most effective overactive bladder treatment. If meds work then stop, I'd check into that.

    I'd also get a new urologist. He wants to put you through a second, more invasive BPH procedure when your flow is fine. It sounds like he just wants to sell you more procedures. It's not likely that any BPH solution will help, so there isn't any reason to review the pros and cons.

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    • Posted

      Thanks for your reply and info. I have always thought my bladder is the main problem even though I have some blockage, and as you said, Mybetriq did help for a while. My doctor did mention trying Botox and I wonder if it would help. However, I wonder how often I would have to get Botox.

      I have made my mind up to get a second opinion and maybe find out what happened to the Urolift and about what can be done about the uncomfortable sensation I now have.

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    • Posted

      Chasing a BPH procedure when your main problem isn't BPH is likely to leave you frustrated and poor. A good URO (which you currently don't have) can address whether you're a good candidate for botox. I know several people who swear by it.

      IF y our flow is OK, don't even consider anything for BPH. Find a better URO doc and confirm that overactive bladder is your issue (almost surely is), then treat it. You will find good an bad reviews for everything if you look hard enough. A competent Urologist will know what will work best. My guess is a 3 month course on another overactive bladder drug, followed (if it the drug works) by botox.

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  • Posted

    My urolift also did not work. It left me worse off and in terrible pain for over 4 months. The pain did not go away until I had a PAE about a month ago. The IR was unable to embolize the left side, so I go back in tomorrow to get that done. I think I'm one of those referred to as "TURP derangement syndrom." I won't do it unless everything else fails. It is a one way street - more men have had serious complications than have been satisfied. It is nearly certain to produce sexual impairment. Like every other procedure, it is dependent on the skill of the surgeon.

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    • Posted

      Thanks for your reply and info. Yes I have TDS for the retro issue. However, I am 77 and still have intercourse but if I live long enough and stop having sex then TURP would easily be an option. Of course with the worse option, then I would not be worrying about anything.

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    • Posted

      ramblin,

      Everyone on this forum who has had a TURP has been happy with the results. Don't know where you got the info that "more men had had serious complictions than have been satisfied." This may have been true of the older monopolar TURP but the newest methods are very effective and I have had absolutely no issues.

      Tom

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    • Posted

      Not close to everyone on this forum is happy with their TURP. There are many horror stories and many good results.

      Bottom line is its a surgery with all the attendant risks and usually results in RE. In skilled hands it typically relieves BPH. But there are non surgical options with low risk for RE that for most men will also do the job. And none of them preclude doing a TURP if they don't work. Seems to make sense for most to try one of those first.

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    • Posted

      I guess TURP is the answer for better flow; however, the chance for retro is high with TURP so I would be one of those unhappy TURP patients. If sex was not an issue for me then TURP might be the best thing.

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    • Posted

      Before having my TURP I read all of the prior posts on this forum going back several years and all seemed happy with the results. I did NOT find any "horror stories". If you know of any please let me know. My experience was good - actually easier than my PAE with better results. I do read every day the "horror stories" of men who have had alternative treatments that didn't work and have gone through pain and retention for weeks or months. There are many here who have said that RE is no big deal. I understand that everyone wants to preserve their sex life but being able to just go to the bathroom and pee and get some sleep is a very, very big deal. RE was not an issue for me, but the retention and constant trips to the bathroom was psychologically draining and constantly upsetting.

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    • Posted

      Well I have experienced RE with Flomax and Rapidflo and did not like the incomplete feeling. As long as I can enjoy sex and do not have to pee through a catheterI am going to avoid TURP.

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    • Posted

      You did not look hard enough. Reports of poor results were many. Less now as most people are having other treatments. At one time some older posters thought that TURP no longer existed in civilised countries.

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    • Posted

      There are easier, less invasive ways of addressing BPH with little to no chance of RE. They don't require anesthesia and for most, work as well as TURP. They make much more sense to try first, as you can always do a TURP if they are not effective.

      All of the surgeries have horror stories attached to them. The less invasive stuff is pretty much confined to "it didn't work". There are men who were left incontinent, impotent or both by TURP/Holep/Greenlight. In good hands, these procedures will work ,but with longer recovery and/or more risk than necessary. And for many, RE IS a big deal.

      I'm glad your TURP worked well - for most, the additional risks that surgery brings are not warranted as a first line BPH treatment IMO.

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    • Posted

      TURP is not the only answer for better flow. It's a last resort. If flow is an issue, Rezum, PAE and Focal Laser Ablation are all good options. PAE is not that effective with an enlarged median lobe.

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    • Posted

      "All of the surgeries have horror stories attached to them." I have been a regular on this forum for years and do not recall "horror stories". I am going to repeat what I have said before - the bipolar and plasma button TURP is NOT like the older monopolar TURP. I have read nothing but positive comments about the newer TURP procedures here going back a few years. From what I have read here the "horror stories" have all been about Rezum and Urolift and GL issues. I agree that RE is a big deal to some but not all. I had a PAE and it didn't do much - the TURP was easier, more effective and had a much faster recovery time.

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    • Posted

      PAE sounded a reliable if expensive procedure from all the early reports. Now we hear of men having three of them. Is that not a horror story?

      I had GL in 2004 (75Grms) and quick recovery and no after problems apart from it re-growing over time to 135 grms. In 2013 I had Thulium/Holmium laser again trouble free.

      As one UK urologist said there are no cures for BPH only treatments.

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    • Posted

      "All of the surgeries have horror stories attached to them."

      I don't know who said that but it wasn't me. I said that there are success and horror stories. And this forum is purely anecdotal - no one should infer that these posts are anything but descriptions of individual experiences - not anything that is statistically accurate or actionable in the aggregate.

      I will repeat (for the last time) that:

      1. In capable hands, TURP, Rezum, Holep and Greenlight all usually offer symptomatic relief - assuming a correct BPH diagnosis.
      2. All but Rezum come with a high to almost certain likelihood of RE.
      3. All but Rezum are surgeries that require anesthesia, which brings some additional risk.
      4. Recovery times vary quite a bit by patient, but for the most part Rezum gets men back to normal life the fastest. That doesn't mean that there aren't men who take months before they can pee after Rezum or that are functionally normal a day or two after TURP. I was back in the gym a few days after Rezum. I don't think that would have been possible with a TURP or Holep.
      5. In the case of a blunder by the doc, Rezum brings the least chance of a lifelong serious complication like incontinence, impotence or both.
      6. Rezum in most cases is the most logical first option - quick, no anesthesia, smallest risk of permanent problems and doesn't preclude doing a surgery if it doesn't work.
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    • Posted

      Derek,

      Before PAE prostate size was about 56gm. As far as I know the entire prostate was embolized. Don't know what the size was before TURP. TURP was more effective and easier than the PAE, which is supposed to be the easiest procedure. However, I am still retaining some urine after my bathroom trips so the TURP didn't completely solve my issues. I suspect that would also be the case for anything else I might have tried.

      Tom

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    • Posted

      I continue to read about post REZUM issues here - weeks of swelling and self cath, pain etc. It sounded like a good idea, but after reading about what men are going through here decided it wasn't for me. For me the "most logical first option" was PAE. Since that didn't do much for me, I had to decide on a second option. REZUM was NOT available to me locally or covered by my insurance, but GL or bipolar TURP were and I decided to go for the TURP.

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    • Posted

      Derek,

      My PAE was covered by my insurance and cost me $250 copay. Having a second one or possibly a third one is not a "horror story", because the whole process is relatively easy. I had to lie in a hospital recovery room bed for 6 hours after the operation and that was very uncomfortable for me - asked for a Foley catheter to clear my bladder. At home there was some pain and discomfort for about a week, not a big deal. All of the BPH procedures are going to lead to some post op issues. There is just no easy fix.

      Tom

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    • Posted

      How much are you retaining ?

      After GL my retention was about 50 ml and my PSA down from 9.8 to 5.0. It was Zero after Thulium/Holmium laser and my PSA down to 0.74 .

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    • Posted

      If it needs multiple sessions it can only be described as a failure. I had no post op issues after either of my laser procedures. Look up some of my older and much repeated posts on the subject.

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    • Posted

      Hi Tom,

      How did you manage to only have to do a copay?

      What state are you in and what policy do you have?

      I can't even get a referral here in AZ. My PCP never heard of PAE so he won't do the referral and my URO won't because he thinks it is too untried & therefore risky.

      So, on my own it's like 22 grand.

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    • Posted

      Michael,

      My insurance is Kaiser. My PAE only cost me $250. Everything else was completely covered. Procedure was done in Oakland, Ca. With Kaiser, you can have anything done by any doctor in the system no matter where they are and you're covered.

      Tom

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    • Posted

      I was told by my urologist that they didn't do many GL procedures anymore because they weren't that effective. So, I went with the bipolar TURP. Very happy I made that decision.

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    • Posted

      Or they did not want to upgrade to the third generation GL equipment. They like TURP because it is a cheap procedure for them and relatively quick.

      My bladder neck sparing GL in 2004 took 58 minutes of lasing time and my Thulium/Holmium procedure in 2013 took 3 1/2 hours.

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    • Posted

      The Thulium/Holmium laser is known to be very effective. I asked about that a couple of years ago but was told they didn't have that laser. An advanced technique.

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    • Posted

      The Holmium used first saves tissue for a histology report and the Thulium tidies it all up. I had 80 grms removed in total with 37 grms for examination. Holmium lasers Holmium laser energy at 2140nm wavelength incises tissue effectively yet penetration is very shallow at 0.4mm, so it avoids the problems of the Neodynium lasers. As the beam is highly absorbed in water it is perfectly safe to fire within the bladder.

      Thulium lasersThulium laser machines produce a very similar wavelength at 2013nm, with physical and tissue properties virtually identical to Holmium, yet with an even shallower 0.25mm depth of tissue penetration. Thulium lasers offer minimal bleeding like Holmium, but are more powerful, so prostate tissue can be efficiently vaporised as with a LBO laser.

      Thulium laser machines are quieter, require less cooling and don't need a special power supply. The beam is also continuous rather than pulsed, and can be used for a much wider range of soft tissue applications, open or laparoscopic kidney surgery as well as ENT and gynaecology procedures.

      Operating room safety issues are relatively straightforward, as at this wavelength the beam cannot penetrate the eye (corneal injury is still possible).

      Thulium laser advantagesStudies have shown that Thulium laser prostatectomy is just as effective as the traditional TURP operation, but offers the advantage of lower rates of bleeding and other complications. It has also been shown to cause less blood loss than Holmium laser prostatectomy.

      RevoLix Thulium laser prostatectomy at Greenlight UrologyThe superior German-designed RevoLix laser used by Greenlight Urology offers a highly effective solution to conditions such as benign prostatic hyperplasia and acute urinary retention.

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    • Posted

      I was studying this very RevoLix laser a couple of years ago, but couldn't find anyone near me who was using it. When I mentioned it to the urologist who does the GL where I get my treatments, he didn't seem to know much about it. So, I didn't move forward with this treatment.

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    • Posted

      If you want information it is distributed by LISA laser USA.

      I got onto the GL trial here by contacting the then makers and their UK rep contacted with my nearest hospital doing it. Several other from the BPH news group did the same. At that time their rep attended as many of the procedures as he could as an observer.

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