Bph scared of turp

i have frequency and urgency go about 10-15 x day .ihave been on just about all meds in the last 3 months with no help.i do not want to have turp done to many horror stories anybody got any ideas? If I leave it go and just live like this do I have a chance of ruining my bladder or kidneys? No burning no blood just keep on voiding. Anyone with the same symptoms? Help

I had those symptoms for two or three years before my system completely stopped voiding, resulting in an emergency insertion of a catheter. Due to the large size of my prostate, the consultant recommended a a HOLEP op which uses lasers to cut away the inside of the prostate. It is now one week since the op and my voiding is becoming more normal each day. It was a significant operation taking three hours under a general anaesthetic.

hope that helps your situation.

Have you had an MRI yet to see the size of your prostate and whether there is an enlarged median lobe pressing in to the bladder/urethra?

If there is, then you may want to research the PAE procedure.  Keep in mind that it works much better for an enlarged prostate that doesn't have an enlarged median lobe.

I was in your situation, let it go just thinking it was part and parcel of aging, and then went in to acute urinary retention from taking antihistamines for hives.  (that was over 2 years ago and I still am in retntion and need to self catheterize.

Good luck!

Sorry that your having a problem  Have you had any test to see what is the problem.  If it is your prostate there is PAE and Uro-lift that may help you  Ken 

Hi Rayluca,  in one respect you are lucky to be living in today's age of 'advance medicine'; there are so many alteratives other than a TURP.   After managing BPH for +15 years with meds, I recently had a Rezum procedure done:  Here is a link to the Rezum blog

https://patient.info/forums/discuss/rezum-have-you-had-this-done--499675?page=2

Others on this site should be able to tell you about other options.  Also, Google it, you'll find alternatives to meds and TURP.  Once you zero in on one that you think might work for you come back to the blog and ask others for feedback.  This site is invaluable in that respect

For sure, to avoid damage to your bladder or kidneys you need to void yourself. 

Don’t get discourage.  Plenty have the BPH issue.  If you look for it you’ll find lots of support, tips and guidance.  You've got plent of company!

Your situation is similar to mine.  About 10 times per 24 hours, never had acute retention, but went for TURP in hopes of sleeping better at night.  Ended up incontinent, at least up to now, 7 months post surgery.

I woud learn about self catherization and have all the supplies at hand in case you ever have an acute retention episode.

Glenn  That is why I feel that a turp is not all ways good.We should try the less invasive procedure first.  I hope that the doctor that did the turp is trying to help you  I will put you on the list for prayers my friend  Ken

Hi Ray,

    I don't know if PAE would be appropriate for you but you shouild definitely inestigate whether it might be. It is the least invasive of the many procedures that are out there. There are several discussions in this forum about PAE, and the procedure is performed in the US, AUS, UK, Portugal and I suspect other places as well.

Thanks for coming here, Ray!   You can learn much from our experiences, and much about the pluses and minuses of each of many alternatives.  I had Urolift done in Decmber, for my situation, which was iffy.  It is the ONLY procedure that can be "undone," so it stands apart form all the others.  But there are some restrictions.

As to your question about ruining your bladder or kidneys:  YES YOU CAN DO PERMANENT DAMAGE!  If you do not completely void, you can wind up with a permanently stretched-out bladder (as I have) or with infections in the kidneys--- you don't want that.

I would strongly suggest that you have both the strength of your streammeansured, AND be measured for the amount of pee that remains after you have voided what you can void.   If that amoiunt is notable (more than 50cc), you should consider learning to self-cath.  Easy to do and we can advise you on better ways than the nurse will teach you!  If the retained amount is 300cc or greater, DEFINITELY learn to self-cath.  Much better, emotionally and mental health-wise, than getting stuck with a Foley catheter and a leg bag.  Seriously.

Good luck!

I sure wish my doctor had mentioned self cathing rather than giving me a sales pitch for having TURP.  I didn't know there was such a procedure until afer my GL procedure led to inflammation and swelling that led to an acute retention episode, and then I went on-line where I learned about it.   I very well would have skipped the TURP and would still have a normal life, rather than living in diapers and pads.

Look into HIFU (high intensity focused ultrasound).  It has just recently been FDA approved for your condition, I know of no side effects.  It was invented 80 years ago and has been used in most countries for 30 years, it works immediately and no pain.

I have had two turps and one greenlight laser in a 13 year span.  If I knew what I know now, I would choose to self-cath until I feel more comfortable about choosing a method to help with my condition.  With the self-cathing, your bladder will empty out till there is only a residue of urine left in the bladder.  You will feel great, having an empty bladder!  This way, according to many on this forum, your bladder will remain healthy and in condition, and not turn useless and without any strength, to push urine out of the body.  So far, it's the best thing that I've done for my bladder!  For more information, go and search for JimJames, on this forum, he has lots of experience with self-cathing.

Hi. First make sure you haven't got diabetes as high blood sugar will cause frequent voiding. Get a urologist to check the size and shape of your prostate. Mine did this in 10 minutes in his office with an ultrasound unit up the backside; easy. I left mine to long and had a bladder twice normal size so don't neglect it. There are various options but avoid standard TURP. I had HoLep which went very well. It does involve Retrograde Ejaculation. I'm in my 70s so not a problem. Look at the other threads on this subject including Green Light laser

Have you considered an opinion on pae? There is a procedure that is less risky than turp and may give you similar results. Had mine done at vascular institute of Virginia where the doc has done more than anyone in the US and have done great since. Always worth a second opinion. Good luck! Keep us posted

"Bloody" TURP, as I call it, can be messy for many, specially if your prostate is large. But TURP had had many refinements, including the laser guided, which should be better and if you search in this site you should get answers.

IMO, if you know a good HoLEP surgeon who has many surgeries to his credit, you may seriously consider that. It is not bloody, has fewer risks, fewer retrograde ejaculation cases (70%), no erectile disfunction usually, etc.. But you need to ask surgeons for clear answers.

Ray, My uro doc recently told me of a case were a patient bled to death due to a TURP.  I did not have time to ask him for details of this incident.  I'm sure this must be very very rare indeed.  Nevertheless, the other possible side effects of a TURP seem more real to me therefore I will avoid having one.   I agree with others above, if meds don’t work for you self cathing is the way to go until you decide on some type of procedure.  At first I was put off by the idea of self cathing; but really, after you do it 3 or 4 times you'll find that is pretty easy ... and, it sure feels good to have an empty bladder.  Really good! 

Ray......I’ve been following this blog for about 9 months and have heard a lot about cathing, drugs, and the various BPH procedures including PAE, Rezum, Urolift, TURP, Green Light Laser and HoLEP.  The following summarizes what I’ve read as best I can.

 

Bottom line:  drugs may work for a while (for me it was about 3 years), but they are not a long term solution and can also result in damage the bladder from constantly being over extended/full.  I used tamsulosin (Flomax) and dutasteride which did help, but eventually as the prostate continued to grow, the effect was lessened. Plus I realized later the drugs zapped my sex drive.

 

Some procedures seem to work for some but not all.  Worse yet, some have reported total incontinence after their surgical procedures.  It’s hard to tell if it was a botched job or not.

 

The best answer imho is surgery, specifically HoLEP.  I did the research on all the procedures (except PAE….had not heard of it), and chose HoLEP.  It is the best surgical procedure because; 1) less time in the hospital and a on catheter (less than 24 hours), 2) less bleeding, 3) very small chance of needing a repeat procedure, and 4) they remove prostate tissue (instead of burning or otherwise destroying it), so they can biopsy it for cancer.  I have heard no reports of anyone having HoLEP and needing a second procedure or experiencing incontinence or needing to continue cathing.  I’ve heard way too many horror stories on this blog about TURP & GL.  My uro explained that they both burn the tissue out, and therefore leave scar tissue.  That tends to shrink over time, and hence the need for a repeat procedure. With HoLEP, they cut the tissue away, grind it up with a ‘morcellator’, push it into the bladder, and then wash it back out.

 

Yes, you the have retro ejac, but sex drive returns, and since I don’t plan to have any more children (age 68), it’s not a problem for me.  I was retaining close to 800ml, and my prostate was 85 grams, PSA 3.8.  After it was 46 grams, PSA 0.2.  I had my surgery in January, and after two to three months had no problems at all.  I did have leakage for 3 or 4 weeks.  Some in the UK report they were told to do Kegel exercises for a few months before surgery to avoid this.

 

I have heard varied reports on PAE which is done by interventional radiologists.  It is an outpatient procedure and far less invasive.  However, I don’t believe it’s covered by most insurance, and because of the iffy results, don’t think I’d try it.

 

Lastly, the experience & ability of the doc is critical, and often difficult to determine.  Hospital ratings for various specialties can be found in the US News & World Report evaluations.  Bios for docs may or may not be available.  For example, the Mayo Clinic was rated best in the nation, and they have the education and publications of their docs listed…… very helpful. Best of luck!

It more they they are letting on.  Most of the time they distroy the bladder neck.  And you get retro.  It's not worth it  Ken 

It's better they having a turp  Ken

My HOLEP doc said said 85% chance of RE. I'm still going that route because there is little chance of needing a second surgery