Bi-Polar TURP at Stanford - second Post

Men's health
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...first Post is stuck in Moderator He!! due to an included link. I will delete the link and try again here.
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Okay here's the first update on my Bi-Polar TURP. Highly recommend Stanford University Medical Center Staff. They are very courteous, knowledgeable, well trained, and caring (to the point of pampering). Proviso - I haven't gotten the Bill yet. ;-)
. Scheduled for 10 am, went in to surgery about an hour and a half late. My procedure was set for 1 hour duration, but actually only took about 35 minutes. Uro later explained that not only did my procedure go very smoothly, he save 10-15 minutes because I had requested the Bladder Neck Sparring technique which means less time actually cutting away material. I spent the night (about 18 hours) with the Foley in with a constant irrigation of saline flushing my bladder. Didn't sleep until about 0300 and was awakened with "Morning Wood" about 0430 with a Pain rating of about 8-9 on the Pain Scale. Luckily that subsided rater quickly as I laid there tryin not to scream out in pain and wake up anyone within 2 blocks of the facility. . They forced me to suffer with a 22 french Foley 3-way Catheter, saying that is the only size they use. If I had known that, I would have brought along a case of these 14 french, 3-way Foley Catheters. Link had to be deleted to get this post past the Moderator.
. The damage and pain from the 22 french Foley was far worse than any of the other parts of my procedure. It has also left me with "Razor Blade" peeing, a Super "Fun" experience for those who have never had to pee through a ripped, chapped and injured Urethra.
. At any rate... I am now 3 days out, and seeing far less blood, lessening pain on urination, and was only forced to CIC "Self Cath" twice since the removal of the Foley catheter. Both times I managed to hold off until bed time. . Will update at 30 days, 3 months, and one year.... if I remember. If not, just presume that I am doing well and went on with my Life. As always, I wish the very Best to anyone suffering from this (or other) dastardly afflictions. . Good Luck Brothers, Chuck

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not there yet but you make me nervaus as one day that could be me.DId you have other surgeries in the past

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Chuck: Thanks for the update. You play up Standford but nice doesn’t cut it. When you are in pain, it should be relieved somehow. You should not have to experience it for long periods of time and they should have had a selection of sizes in catheters. I’m sorry you had to go through that and I hope and pray for your speedy recovery. I hope the procedure is a complete success. Keep the faith.

Vern

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No other procedures/surgeries previously.
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I know it’s normal to be nervous, but use that nervousness to help You make the Best choice for You.
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I am Very Grateful to Jim and Ken for all their knowledge and encouragement on CIC. I’m certainly glad I had previous experience with CIC, especially when I started blocking up and couldn’t pee after they pulled the Foley out. Otherwise I would be stuck with the Foley for a week, or two weeks, or more like some other folks.

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Vernon,
They offered me pain pills / medications of All flavors. I refused all of them. And then they even sent me home (4 hour drive) with Tramadol, an opioid / narcotic for moderate to strong pain. I ain’t using that neither.
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You are correct on them utilizing different sizes; verses stuffing up their “One Size Fits All” garden hose. But that’s the way they were trained. I believe if I had brought some along, they would have considered my request.
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Thank you for your hopes & prayers, I sincerely appreciate that.
Chuck

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Chuck: All I can say is, you got guts. I would have taken the pain meds and probably asked for more. It is not in my nature to tough it out through pain when there is relief at hand so hats off to you for doing it.

Vern

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I was stuck with a Foley for two weeks after REZUM and thought I would have to self cath but I lucked out. The peeing seems to be getting better after three weeks but still bloody at initial flow. I’m told it could take over two months before the urine is clear of blood. I think I am getting better but still too early to tell at three weeks. Thanks for your input.

Vern

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Hi Chuck, can you elaborate some on the discussions you had with your urologist at Stanford regarding bladder neck sparing? Is this something they routinely offer on request? Does your median lobe/bladder neck anatomy have to meet certain criteria for them to agree to it? what was their overall opinion on it? Also, do you know if he used a button or loop electrode? Or maybe both?

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Russ,
I new I wanted to spar my Bladder Neck before I even went to Stanford. I wanted a PAE, but my IR Doctor said (after viewing the CT scan and Cystoscopy) that I wasn’t a great candidate for PAE. My prostrate was 38, and they want it to be in the 50 to 100 range. Normal prostrate size is about 14. Some (mine) prostrates grow in-ward and squeeze the Urethra more than other prostrates; which can grow quite large (150) and still allow urine to pass through the Urethra. Although usually the back-pressures cause the Bladder to distend and get stretched out, when urine is not fully voided. Stanford said that I could have whatever I want… if they have it as part of their surgical procedures. Bladder Neck Sparring techniques are very common nowadays. I believe my Bi-Polar TURP was Loop. With possible Button to smooth out the final surfaces; but I will ask at my next follow-up visit.
Chuck

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Good Luck Vernon. I wish you All the Best in your Healing and Full Recovery.

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Chuck,

I had a bipolar TURP in April and did NOT stay in the hospital overnight. I checked into the hospital at 6am and was home by 10:30am with a 20fr Foley in place. That lasted for three days, and I removed it myself in the shower, then went to the uro office for a voiding test, which I passed. The irritation from the Foley was the only discomfort I experienced from the entire procedure. No pain, almost no blood once the Foley was out. The reason the doctors put in a large Foley is so that any tissue particles and blood clots won’t clog the eyelet in your bladder, so my Foley had double eyelets. I had no blockage issues and few particles or blood clots in my leg bag.

Looking forward to your updates.

Tom

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my doctor used a french 26 cath 3 way on me, had it in for several weeks afterwards too, along with a Superpubic.

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Kenneth,
I swear that damned 22 Foley i suffered through ripped me up. I don’t know how you could stand that 26 french Foley. Like Tom said, if it wasn’t for the Foley catheter, the operation is not bad at all.
Chuck

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Tom,
Right you are. The Foley was the absolute Worst part.
Chuck

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i did’nt move around much thats for sure ! actually it was pure HELL .

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you make me nervous as one day that could be me

You should not generalize based on one post. I had the same procedure, including 17 hours of continuous bladder irrigation, went home without a catheter and never had an issue other than the typical frequency/urgency and burning for the first couple of days. By 3 weeks, I had resumed all normal activity with my doctor’s blessing. Nine months out and everything is still fine.

Everyone is different. You have to go into any procedure with a positive attitude. IMO, anyone with a negative attitude is almost guaranteed to have problems.

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Hi Tom:

I guess I’m not thinking clearly today, but why are tissue particles and blood clots coming out of the Foley catheter? As I understand it, the end of the Foley is inside the bladder and the operation was done on the prostate. I know that some procedures push the removed tissue into the bladder and then morcellate it, but didn’t think that was the case for TURP. Or maybe it is as a method for removing tissue. Maybe you can explain it to me. Thanks.

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I guess I’m surprised about having an option to select a bladder neck sparing procedure. Isn’t that what a man would always want? Wouldn’t every guy want to minimize the chance of incontinence?

Since this seems obvious, there must be other issues at play. I think another poster alluded to an enlarged median lobe. Perhaps if a man has an enlarged median lobe, it is much more difficult to do a bladder neck sparing procedure. Any other issues that posters are aware of that would prevent a bladder neck sparing procedure.

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Yes, I would also like to know why I still get blood in the urine three weeks post REZUM procedure. I thought the dead tissue was absorbed by the body, not flushed out through the urethra. Can somebody explain why there is still blood in the urine after three weeks?

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Vernon:

I think that would be different for you. Although Rezum does not destroy the section of the urethra that passes through the prostate (prostate urethra), it does puncture the prostate urethra in order to inject the steam. So the puncture wounds could still be causing issues 3 weeks later.

But for my question, the urine is traveling from the bladder through a fully enclosed catheter and then out the penis. Unless the catheter has holes in it, I don’t see how tissue from the prostate could enter it (for TURP, the prostate urethra is destroyed). It seems to me that any material coming out of the catheter has to come out from the bladder (but I’m not saying that that tissue is bladder tissue).