Which is the best surgical treatment for benign prostatic hyperplasia?
Posted , 19 users are following.
I'm sixty two years old and have been catheterized (for now just over six weeks ) after being hospitalized for urosepsis following a cystoscopy. I'm waiting for the TURP procedure on the NHS although I believe there may be better surgical procedures and I am prepared to pay privately to get the best result. Any thoughts, information and/or weblinks would be most welcome. Thanks. P
0 likes, 103 replies
raffie PetW
Posted
There was an article in the NY Times called "Alternatives to Surgery for an Enlarged Prostate". Talks about options currently out there. Don't know if moderators will allow link but here it is.
https://www.nytimes.com/2019/08/26/well/live/alternatives-to-surgery-for-an-enlarged-prostate.html
Raffie.
PetW raffie
Posted
Thanks for this raffie. The link works but I haven't got a subscription so can only see the first couple of sentences. Nevertheless the link works. Thanks
geoffrey61005 PetW
Posted
Hi. i have recently had the urolift proceedure which resulted in the urethra being completely opened. i went in at 10am and it took 10 minutes. post proceedure there was very little pain, not as much as the cystoscopy pain. home at 3pm and by 5pm urine was running clear of blood etc.
my symptoms were not improved much as my bladder had lost elasticity due to pushing urine past the obsructed urethra for 4years. its a great proceedure but ask urologist the state of yr bladder when doing cystoscopy.
do a little research of urolift and turp as i understand turp can leave you with ongoing problems.
ps urolift does not normally require a catheter afterwards.
Geoff,72.
PetW geoffrey61005
Posted
Sounds great - but my uro thought that I'd need a little more than this. But who knows this could do the trick for me too. The main thing is that I need more information from my specialist before I can make any kind of informed decision. Thanks geoffrey
derek76 PetW
Posted
As you went to an NHS hospital do they have a range of prostate procedures ?
At my local hospital they said that they only did TURP which I refused. I did then elsewhere see one of the two UK ones who were the first to do GL in the UK. He felt that my symptoms were not too bad and could wait for a while.
At my next visit to the local hospital I saw a Locum who gave the TURP teams game away by telling that one of the nephrologists had been doing prostate laser surgery for years and referred me to him. That may be another path you can follow. He did Thulium/laser surgery that is basically the same as RevoLix Thulium laser that you can Google. He was one of the leading exponents and demonstrates it around the world. I was amused in one Youtube video when he complained that the prostate given to him for the demo was much smaller than the ones he was used to.
Strange he complained that mine 175 grms was too big and that I had ruined his back by having to crouch between my legs for three and a half hours. By contrast my 75 grm one with GL took 57 minutes of lasing time.
PetW derek76
Posted
My local hospital doesn't have a range of procedures - they only do TURP. I'm prepared to travel for better care but am still confused as to which procedure would best suit me. Again I need to know more about exactly what my problem is and what would be the best procedure for me. My prostate looks very intrusive as I mentioned earlier - on the cystoscope it appeared like an anal sphincter as the camera approached it but I don't know whether this is the normal look of the prostate on such a scope.
derek76 PetW
Posted
Even the major London hospitals don't have a range of options. I went to the Freeman in Newcastle and managed to get on to their GL PVP trials in 1994 with all five Uro's going it I don't know if they stopped TURP after that. I had kept in touch with the one who did mine as they wanted feedback from patients and asked his advice when it regrew. He said that they had continued to be satisfied with GL but after trials of HoLep they had taken a vote and gone for HoLep on a split decision.
At least two posters on here from TURP zones have managed to be referred to Newcastle for HoLep as NHS patients and have been very satisfied.
richp21 PetW
Posted
I would also look into PAE. It is far less invasive and has fewer side effects than most if not all other procedures. It is performed by interventional radiologists (IRs), not urologists, so your urologist is less likely to mention or recommend it. There are multiple discussions on the forum discussing PAE or of reports from men who have had PAEs. I had one in March 2017 and while it only provided marginal improvement, it was enough for me to get off the meds. Happy to send a link to the detailed report thread of my experience if you are interested.
Rich
derek76 richp21
Posted
It beats me why people accept marginal improvement at great expense when even TURPs give more than that while laser procedures in my experience and that of friends solved our problems without retro. One in his 60's even fathered a child with his much younger girl friend.
PetW richp21
Posted
Thanks for the info rich - by all means send the link if you can
PetW derek76
Posted
Fathering kids after any such procedure is a testament to its success.
richp21 PetW
Posted
Hmm. I can't find the thread on the forum anymore. I'll try some more, but it doesn't look promising. Happy to answer any questions that you might have about my PAE experience.
richp21 derek76
Posted
Hi Derek,
Medicare covered my PAE. Main reason I chose PAE is that it is far less invasive than the other procedures.
Rich
derek76 richp21
Posted
Indeed it is but with GL I had no post op problems. It took me about 6 hours to pee after the catheter came out at 6am. It was slowish all day and I had retention until the next afternoon so they kept me another night as I had a three hour train journey home. Fine after that with just a little spurt of blood at the start of urination and a bit of stinging but I was OK to go the races the next day and out for over six hours without constantly thinking toilet as I had the week before.
PetW
Posted
I've got a date for the TURP op at my local hospital (27th Sept 2019). The guy who is going to do the TURP is not yet registered with the British Association of Urological Surgeons and is not yet registered on my local hospital's website; as I'm told he only became a consultant in July 2019.
I've a chance of HoLEP at another hospital but have to wait for this for 6 months - I am catheterised with a Foley which is restrictive and not comfortable.
If you were me what would you do?
PetW
Posted
PS I've asked my local hospital for a surgeon who is registered already with the BAUS and the hospital's own website rather than this fellow - and I'm now waiting to find out the availability dates for another surgeon.