Why Retro?
Posted , 13 users are following.
So, I have a question that perhaps someone here can answer...
Other than a few procedures like Urolift, PAE, HIFU and FLA (there may be others) why do procedures (like TURP, REZUM, Button TURP...) cause RE and can they be performed to reduce BPH symptoms but also avoid RE?
I’m referring to procedures like TURP which somehow cause RE. Can’t these procedures be performed so as not to damage the bladder neck and avoid RE or is that not the issue?
0 likes, 36 replies
rdemyan ES28567
Posted
I have a note from a post on HOLEP regarding Dr. Nicole Miller. Someone who had the procedure done by her posted that she tries to minimize the chance of incontinence. I'm not sure if this would apply to RE. Here's the text of my note:
"post says that she leaves a little bit of prostate tissue around the urethral sphincter which she said would help prevent incontinence issues."
Obviously I can't vouch for the veracity of this post. I wrote the note in case I consider BPH surgery since she would be one of the doctor's I would speak with.
rdemyan
Posted
I should add that Dr. Miller is at Vanderbilt University.
kenneth1955 rdemyan
Posted
Rdemyan
Good evening.
It would also depend on if they stay away from the Ejaculatory Ducts and it also would depend on how much of the tissue she get rid of by the bladder neck because that is were you seminal channel is. If they get rid of that you may as well forget it.
Have a good day..Ken
ES28567 rdemyan
Posted
That is an interesting theory. If she really does that in an effort to preserve continence then she has my respect.
ES28567
Posted
In a conversation with a uro, he told me the bladder neck is unable to close after a turp. He did not explain why.
I do not know anatomy well enough to comment intelligently on the subject but it would seem somewhat logical that if they would stay away (or stop short) from the bladder neck, perhaps there would be less chance of incontinence and RE.
You would think they would have tried this and perhaps it didnt help or perhaps it is just impossible/unavoidable to do some of these procedures without doing damage to the neck.
kenneth1955 ES28567
Posted
Hey Buddy
That is because when they do the Turp they start from the bladder neck and shave it down going all the way around to make the tunnel.
With Holep it all depends on how the doctor does it. Some only take half the tissue and stay away the the ejaculatory duct. Others will core out the prostate and leave shell. With the shell you will have retro. And with a button Turp they have more control of the button and what they take out. And stay away from the duct and the bladder neck.
Remember you need a good doctor that cares enough to take there time and not rush like what Bob's doctor did
Have a good night or morning.Ken
kenneth1955
Posted
Bob and I7016 did...Sorry
bob80972 ES28567
Posted
I had holep about 6 weeks ago.....no RE.
l70106 ES28567
Posted
I had a button turp about a year ago and I'm very pleased that I don't have RE.
I met with five different urologists until I found one who was willing to perform the procedure, which included staying away from my ejaculatory ducts and being very cautious around the bladder neck.
The average length of time to have a turp procedure done is usually one and a half hours.
But because my urologist was so patient and cautious, and wanted to make sure that I was happy with the results, my procedure took three hours.
I found that most urologists are unwilling to spend that length of time for a turp procedure.
The key is to find a urologist who is patient, meticulous and willing to take whatever time that's needed to prevent RE.
tom86211 l70106
Posted
Can tell us what you experienced in the days and weeks following your button TURP? If you had a Foley catheter in how long was it in? What about post op pain and bleeding? What about sleep issues, etc? Thanks for any info....
Tom
l70106 tom86211
Posted
Tom,
After the procedure, when I woke up my urologist had placed a foley catheter in me.
He suggested that I keep it in for at least 4 days.
To be on the safe side, I chose to keep it in for 7 days.
Here's the weekly breakdown after the catheter was removed:
Week one, every 2 to 3 hours I had to go urinate.
Week two, every 3 to 4 hours I had to go urinate.
Week three, every 4 to 5 hours I had to go urinate.
Week four, every 5 to 6 hours I had to go urinate.
Week five, I was back to my normal routine, able to sleep
7 to 8 hours before I needed to go urinate.
There was a little bleeding the first 2 weeks. No big deal at all.
As far has pain, my doctor prescribed some pain medication,
but I never had to use it because I was never in any pain.
The most challenging part for me was constantly going to the bathroom the first few weeks which prohibited me from getting a good nights sleep.
Hope that provides you with more insite on my button turp experience.
Needless to say, I'm very pleased with the outcome.
tom86211 l70106
Posted
Thank you for your detailed reply. "The most challenging part for me was constantly going to the bathroom the first few weeks which prohibited me from getting a good nights sleep.". That's what I am going through now - up every hour to hour and a half all night, so I never get a good night's sleep. I had a PAE about a year and a half ago, but now I am back to where I was before that treatment - a bit worse actually. I have been exploring the various procedures and a big part of my decision is the post op side effects.
Thank you,
Tom
Waffalobill ES28567
Posted
i had turp and dont have RE so it can be done.
donald16398 Waffalobill
Posted
Same with me.
glenn77 ES28567
Posted
In this discussion, keep in mind that BPH with median lobe growth seems to be a special category, as there may not be a great increase in the overall size of the prostate, but the median lobe will grow to protrude into the bladder. When there is protrusion into the bladder, reducing or elimination the obstruction without damaging the bladder mouth function requires special care.From all that I've read, the FLA procedure done by an experienced doctor gives the best chance of a good outcome.
I had median lobe growth and, unfortunately, was directed to a urologist whose prognosis scared me into having TURP. The result was a complete disaster in all respects. First, he damaged the external sphincter causing high level and permanent incontinence.I was fortunate to find specialist who implanted an AUS, which works well to control the incontinence. I just have to accept the ED and retro that came with the six procedures I had over a two year period, and also accept that the AUS could require revision surgery in the future.
kenneth1955 glenn77
Posted
Hey Glenn
I am sorry for what you were rushed into and the side effect you have to deal with. Right now there are other option over the last few years that have com up.
We have had some doctors on here that are doing a mini Turp with a laser. With this they just address the median lobe and do not touch the rest of the prostate and or the bladder neck. The men that had it done had no side effects and no retro.
We also have the new procedure from the Urolift company called the Midlift. This is where they pin the median lobe to the one side out of the way. This was just approved last May and there are doctors trained in it around the country. I have gotten the addresses for some of the men from the company. More doctor are going to be trained. My doctor has already done a few with good results.
You just have to research the procedure because there is always something else less evasive out there that can work.
Do your research and don't let a doctor scare you into any procedure luck Glenn was.
Take care....Ken
steve07664 kenneth1955
Posted
Is there another name for the "mini Turp with laser" procedure? I tried googling that without getting a clear result... Thanks...
kenneth1955 steve07664
Posted
Hey Steve
I'm going to have to look for it again and see who was the guy that had it done. That was the way his doctor did the surgery. She called it a mini Turp. She only removed the median lobe and I also read one that only got rid of the prostate on the other side of the seminal vessels
Both did well and no retro. I will let you know...Ken
steve07664 kenneth1955
Posted
Thanks... the protruding median lobe is definitely my main problem...
kenneth1955 steve07664
Posted
Hey Steve
Still looking to see if I can find some more information on the Mini Turp. Like you said there is not much on the internet. I think that is because it take time to do it and most doctor are not going to do it. They just want to go in and get it down.
I was reading on another site. This guy ask a Urologist about a mini Turp to avoid the bladder neck and because he does not want retro. The doctor told him that there is no thing like a mini turp. That retro is a giving with any prostate procedure and after 40 you don't need to ejaculate. It just something you have to live with.
Let me say the guy said a few not so nice words and the Urologist got off the site. If you look on the internet you can see that they have different procedure to stay away from the bladder neck and to save some of the tissure. You do not have to get rid of everything to pee better. You just need to get rid of the tissue that is blocking.
Steve do you know that Urolift came up with a new procedure for the median lobe. It is called the Midlift. It was approved last May by the FDA. There are a lot of doctor that have been trained. Let me know when you are and I can get you some information. If you want to check into it. They can take the median lobe and clip it to one side so it it out of the way.
I will let you know if I find anything else out....Ken
steve07664 kenneth1955
Posted
Hi Ken, thanks for the followup info. So the urologist I'm currently going to was actually the lead researcher on developing the Urolift procedure. And he told me at my last visit that he totally disagrees with the decision by the FDA to approve the Midlift procedure, that he thinks it's impossible to be effective, and that he's never done one on any of his patients. It was pretty disappointing, since once they disqualified me for the Rezum procedure, the Midlift was probably my best hope for relief without drastic surgery.
Then again, this was the same urologist who has a similar opinion about retro as the doctor you mentioned. He seriously asked me once why I thought having a lifetime side effect of retro would be a problem. (I think if anyone has that question, they should take Flowmax or Rapaflo for a few days, and experience the retro for themselves...)
All that aside, it seems like the idea of a "mini Turp", where they're just removing the obstructing tissue, is pretty logical. I'm going to ask him about that at my next appointment in a few weeks.
kenneth1955 steve07664
Posted
Hey Steve
Well he is only one doctor there are many that are being trained to do it. My doctor did a few before. He and his partner will be doing them.
If you want let me know where your at and I can ask the company if they have a doctor in your area. No harm in asking I have done that for about 5 men on this site.
A mini Turp would be a good idea but you have to find a doctor to do the procedure but I would have to have it in written and I would not sign anything till I read the form Because they can do anything to you once your under and after it will be to late.
Just lat me know my friend....Ken
steve07664 kenneth1955
Posted
Hi Ken, I would appreciate that, thanks. I'm in the Dallas, Texas area.
(And I'm currently on my 4th urologist...)
glenn77 steve07664
Posted
Steve,
I haven't' read this entire thread, but wanted to point out that there's a doctor in Houston, Dr. Karamanian, who does FLA procedures to reduce BPH obstruction. Rather than being a trans urethra procedure, it's done via the rectum. Dr. K is an internationalist radiologist. His downside, I think, is that he works on a cash payment basis, so you may be paying abour $25 K out of pocket.
kenneth1955 steve07664
Posted
Good Afternoon
Hi...Steve
I will send them a e-mail and let you know. Sometime you have to go through a few to find one that is willing to work with you.
Ken