Which is the best surgical treatment for benign prostatic hyperplasia?

Thanks for this atc. I'm now in a complete quandary. I'd prefer the HoLEP procedure but it is a six month wait for this on the NHS and I'm concerned about infection and I've had one already. I've got a TURP organized by the NHS for later this month and I'd take this, despite the risks of the procedure but the guy who is going to do this procedure I cannot find on any professional site. I've looked on the British Association of Urological Surgeons website and this fellow is not included there. I've also looked on the Hospital site too but as this guy is a locum he is not listed there either. So my real concern now is; is this guy actually a qualified surgeon? Is he genuine? Sounds incredible I know but I can't find his name on anything other than LINKEDIN and ResearchGate - on both of which I'm enrolled. It's possible to write your own quals on both of these sites - I know this as I've done it myself (I've been honest about mine, though many people I know on Linkedin have said people often write bogus quals). Any advice atc. This goes out to all other contributors here too

I can only think of two things which might help you;

1. Contact BAUS (Tel no on site) and ask them why you can't find details of your surgeon on their site. I would be amazed if he was not a properly qualified surgeon but understand your concerns.
2. Contact a local Nuffield or Bupa (or others) and ask for a second opinion in the hope that they would answer your worries on the surgeon and/or provide you with an alternate plan (at a cost of course).

I didn't mention on original message that I was discharged from hospital on same day as Holep procedure which I suppose gives good indication of the operation size (I'm aged 70 BTW).

I would never advise anyone what to do in a major medical situation so I'm just setting out ideas and experience details.

If your local NHS hospital has a long waiting time you are entitled to ask to go to one with a shorter waiting list but you will probably need to find it for yourself and get your local area health authority to pay for it.

I went to the Freeman In Newcastle for GL when they were doing trials on. Seek out posts from Breeze he went that route by first phoning the Freeman for HoLep.

Many thanks atc. Will do!

Thanks derek - I will try to seek out a shorter list. Thanks again.

Which area do you live in ?

When GL first came to this country in 2003/2004 I contacted the makers to ask which hospitals were getting the equipment, They put me and others in touch with their UK rep and he was helpful in putting us in touch with hospitals.

I cant find who makes HoLep equipment but if you can that might be a route to take. Your present hospital should be able/willing to tell you.

At least I got one only a 130 miles away but a friend in the remote North of Scotland was given a London one but the NHS actually paid his train fares for his initial appointment and for the surgical one. I didn't ask about that.

Thanks derek. I from East Lancashire but anywhere in Lancashire Liverpool and Greater Manchester would be fine as would - at a pinch - West Yorkshire (Leeds Bradford area).

Hi Pet,

could you please tell me what were the symptoms of your infections?

I believe I have been having UTI for two months non-stopped since the catheter was inserted and even

when it was removed for 3 weeks after PAE.

Also could you please tell me if you were placed on antibiotics when they removed the catheter?

Thank you.

Alex

Symptoms were : smelly urine/catheter (usually first sign), cloudy or bloody urine, penis pain (only on 1 of the 4 occurences) and fever (terrible shaking on 2 of the 4 fevers).

No, I wasn't given antibiotic on catheter change or removal.

Alex

My experience was as atc mentions a smell - mine was a fishy smell - specs of blood in my urine - and on one occasion terrible shaking as he also mentions.

When my catheter was first inserted I had bloody, red urine for the first 2 days. I even went to ER, but the line was for a few hours, so I left. Then I started getting cloths of blood. I contacted my urologist and he told me everybody with catheter gets blood in urine. And so it went.

I would like to ask you please if you used bags with the catheter or you used a valve? I have read that using a valve could reduce chances of an infection, not to say that it is healthier for the bladder, and you need no bag. My urologist did not like the idea of a valve, but I have heard it is popular in England.

Thank you!

alex

I use bags with my catheter. I don't use a valve though I've been advised that I should use one if this thing is going to stay in for a long period. The latest (larger size) catheter has given me little problem. With this catheter I have not seen any blood so far and it has been in a month. I had a lot of specks of blood with the other smaller catheter. Is your catheter the right size for you?

I've a day bag which is kept on for a week and then changed (we do this ourselves) and a night bag which is attached to the day bag at night and discarded in the morning (night bags are only used once and then thrown away). The catheter I had originally must have been for a child and erections must have been prevented with this damn thing. With my current catheter - though my penis is of average size when erect - it allows me to get some kind of erection though not full. During the day I try to avoid any sexual thoughts and distract myself if I catch my mind wandering that way; but I can hardly control what happens when I'm asleep. Strangely enough we (my wife and I) think I has some nocturnal emission last night (I vaguely remember a mildly erotic dream) which has given me some trouble today - possibly bacteria attaching to it (I'm no expert so who knows). We've treated this with some antibiotic cream our GP prescribed for me. It seems to be easing the nipping at the moment.

The valve sounds a great idea - I shall ask my GP what he thinks of this when I next see him. Hope this helps - but to repeat I'm no expert so what I'm saying here could be a load of nonsense.

Thank you!

I am not sure about the size of the cat but it should be an adult size because I am treated in adult medicine.

It is interesting that you do not reuse night bags.

Do they provide the bags for free? What type of coverage you have?

I live in USA. They allow a new both day and night bags only one time in 15 days.

No wonder one gets infection after infection.

Yes I get them for free on the NHS. We have relatives in Germany and things there appear better still. In Germany catheters are changed if they are silicon every month - and if rubber they are changed sooner still. Silicon catheters here in the UK are changed every 3 months by the NHS or so I've been told. Of course if I have the operation later this month then it will be removed prior to this. There are different sized catheters even for adults as men differ in size I guess. The one I have might not be a perfect fit - it isn't - but it is a hell of a lot better fit than the last one and this appears to have made a difference not only in discomfort level but also in terms of reducing\eliminating visible blood specks. There may be blood in my pee but I can no longer see it whereas as I mentioned blood specks appeared with the small catheter. Incidentally putting the antiseptic cream on my penis earlier today appears to have reduced the stinging from last nights 'nocturnal adventure' To repeat day bags are changed - we change them ourselves - every week and the night bags I throw on waking. Everything is paid for by the NHS. Hope this helps

A urology nurse once explained online how to have sex when wearing a catheter.

I should have saved it for others.

I don't see how it's possible.

My catheter is changed every month for 10$, but as I said I am forced to reuse bags. Do you take any medicine to prevent the infections? What kind of surgery you are going to have?

If you have an urology appointment ask.

alex

I don't take any medicine to prevent infections. When I had urosepsis due to a cystoscopy which left me in this state (catheterised) and was hospitalised obviously they gave me antibiotics to control the sepsis; intravenous Gentomicin appeared to get things under control. Later after a couple of weeks at home as I mentioned earlier I had the fishy smell emanating from my penis. I saw my local GP and she prescribed a week's supply of oral antibiotics which appeared to work. But if things are ok as they appear to be at present I don't take any medication to prevent infection.