After my cystoscopy yesterday, I met with my urologist-surgeon to talk over options. I'd told him I was seeking out the Green Light laser treatment and he said that was fine, he could send me to someone for that, but that the surgery he performs, the bipolar vaporization was going to give me the same results with the boon that there is way less post-bleeding complications related to bipolar vaporization. I told him I'd heard such rave reviews about Green Light and he said a lot of that is heavy promotional efforts on the part of the Green Light manufacturer. But, again, he'd send me to someone for that if I felt it was a big difference. In the end I decided to go let him perform the surgery as I didn't have a sense that he was BS-ing me or trying to sell me something I didn't want. He said I could do either spinal or general anesthesia and I think I want to just be knocked out rather than partially awake and observing things. The only bad news for me was that he said I would have RE due to the major obstruction in my prostate involving the bladder neck in my bladder. I'm not thrilled about that, but if that is the trade off for constant cath-ing, well, so be it. Any thoughts from you guys here about my decision?
"Bipolar Vaporization" Do you mean Button Plasma Turp? Personally, I think button turp is better - it does a cleaner job more precise job.. Green Light seems messy to me. Just look up videos on YouTube showing these procedures being done on real men.
Forget regular Turp.. IMO, I believe it's barbaric, non-precise, messy, and could create too big a channel which may lead to urinary incontinence. Only my opinion of course.
Aquablation would be a fine choice, but it's expensive and not covered by insurance yet.
A good button turp surgeon may also be able to avoid the ejac ducts to a certain degree, so retro ejac risk could be lesser with the button.
Heavy promotional efforts are hardly needed on a procedure that has been around for more than 15 years and has been well written up. Why did you not consider Holep ? I had no post op bleeding after GL and only few blood clots as it seals off blood vessels.
I would look into Rezum. It's less invasive than the other things you're considering, doesn't require anesthesia and rarely causes side effects. RE only happens about 10 % of the time. And it usually works just as well as Greenlight - and if by chance it doesn't, you can always have something more invasive done.
My original urologist also recommended a bipolar TURP for me as well. Why? BECAUSE THAT'S ALL HE DOES! However, I did NOT get the TURP done. I didn't want the RE or the long recovery period, etc.After a lot of research, I ended up with a Rezum procedure in January 2018. You owe it to yourself to find the nearest location where the Rezum procedure is done and at least talk to them about it. Everyone on this forum has an opinion about what the best procedure is, but if you do the due diligence in researching the options, I believe that you will find that the Rezum procedure is, for most men, the most logical first procedure to have done. As oldbuzzard mentioned, you can always have a more invasive procedure done later (although it's extremely unlikely that you will need another one).
Hello Buddy
Well I tried to find some information on this procedure and there is not much. But I did find out that they feel that it may be better because of the less bleeding and also they found out that it does cost less to do it However long term fellow up and more randomized trails are needed to validate the value of the Bipolar Vaporization.
I read your last part and I can feel that you are not happy ( He said I will have RE ) There have been to many men on here that the doctor either cuts or laser the bladder neck and end up wearing pads or diapers. And with the RE Issue you should not have to settle for anything. He should be able to take care of the prostate blockage and leave the bladder neck alone. Removing the prostate tissue will relieve the bladder neck.
Now if I were you I would go talk with another Urologist that he does not know. Go and see what the doctor will say about The Green Light Laser. There are a lot of trails and article that this procedure has done great and retro is only at a 65%. Better if your doctor is good.
To me it also seam like he was pushing his procedure just like he said that the GL people are doing. But he must be a good sale men because you went for it.
Please don't rush because once it's done it done and you will have to live with the outcome not the doctor
Take care and good luck............Ken
Hey Ken
That is very good advice. Men need to give there self options. Start out with a less invasive procedure
Take care..........The other Ken
have you considered the reZUM PROCEDURE?
bipolar bipolar turp is not a bad way to go. You will have incredible q-max and much lower PVR after the procedure. my rezum was not that effective and I'm thinking about doing the bipolar turp. Please let us know how your experience is after you have the procedure.
retrograde ejaculation shouldn't be much of a problem. The thing I'm worried about is a small but real risk of impotence. What do you guys think about erectile dysfunction after bipolar vaporization?
Hey John
If you end up with being impotent from any of the procedures, retro ejaculation is the least of your problems. There is all ways that chance when they cut away at your prostate they may hit the nerve bundle and that will be it.
Men do not take in account that some doctors do not care about your sex life. There main concern is to get you to pee better. But I am sorry no men should have to give up his sex life just to pee better. That is why you have to do research and get a second opinion. Find a doctor that will listen to your concerns. And just because you are not having any more kids. Why is the doctor telling you that you don't need it. He is treating you like a old horse that they put out to pasture.
Don't listen to them when they tell you all will be the same because 9 times out of 10 it's not. If you want to feel what retro is like have the doctor give you either Flomax or Rapaflo. And see how you like it.
Life is to short to not live it to it's full potential. I guess holding hands will be the best. Ken
good points. thanks
I'm just under two weeks post-op GLEP. from what I've gathered my doc only removed the median lobe, and probably not all of it. So far I'm very happy with the procedure and yes I am having sex already, and do not seem to have RE, the volume may be less (not sure) but sex is possibly even more enjoyable now than ir was which is hard to believe.
My doc does several procedures but is a pioneer with GLEP, he felt it was the best for my situation and i trust his judgement. He did mention that when he gets referrals for guys that have had prostrate surgery and have symptoms again that unless they have RE he knows the job was probably not done well enough and he will have to go back in.
I may just be lucky with GLEP, do your research.
My insurance will not cover Rezum...and I do not have those kind of funds for it.
I have a meeting with the Green Light doctor next week, just to hear his take on things.
I was hoping for that too, the avoidance of RE, but he told me the main problem with my prostate is how much it is compromising the bladder neck, and apparently that area is the zone that has the ejac ducts.
Hey Rick
Glad to hear that all is going well. You may see a little less but you still have it. That is a sign of a caring doctor. What he did is removed the blockage. Why remove the whole prostate if you don't need it. I praise your doctor for being a good man and a good doctor.
Heal well And be safe...........Ken
What is q-max and PVR?
Rick
How was post-op for you with GLEP. Regarding bleeding and clots or issues like that. And how long were you cathed after?
Can you explain more what you are saying here: "He did mention that when he gets referrals for guys that have had prostrate surgery and have symptoms again that unless they have RE he knows the job was probably not done well enough and he will have to go back in."
Try appealing it - or if you can, wait. Rezum will probably be covered by almost everyone before too long.
But an appeal is definitely worth a