Habe heute Urolift-Verfahren durchgeführt

Männergesundheit
1

Went in this morning for a urolift and things are going better than I had feared. The procedure itself was pain free. The doctor had me take hydrocodone an hour before and gave me nitrous oxide while it was happening. Not sure if I felt any pain but, if I did, I was so out of it that I really didn’t care.

After the procedure, the initial recovery was a bit rough. Felt really nauseous for a while with a really strong sense of needing to pee, but when I tried to urinate there was pain and very little came out. The nurse said today would be that way. Over the last few hours, the symptoms have decreased but not disappeared. The experience is uncomfortable but not horrible. I’ve not needed any more hydrocodone. Just taking Motrin and Tylenol now because I hate the feeling of being “high”.

It’s way too soon to know how effective the procedure will be. Today, I’m having to pee frequently and the urine is of course filled with blood and clots. It’s hard to start and the stream is weak. But I was told to expect all of the above.

I’m pleased that things aren’t worse. I was fearful of the recovery. Particularly the first day. It hasn’t been bad. Will post again as I progress over the next days, weeks and months.

For context, I’m 58 years old. Have had BPH symtoms for 20+ years; early onset runs in my family. Was on medication for the last ten years (Tamsulosin and Finesteride, which are generic Flomax and Proscar). Didn’t like the side effects and things were getting worse. I’m off the Finesteride now and hope to go off the Tamsulosin when things shake out. The doctor had done a cystoscopy and determined that my prostate does not have a median lobe. He didn’t think it was too big for the procedure. He was concerned about tissue that looked like a tongue right where the bladder meets the prostate. Said that, without that, he’d expect me to have a 95% chance of at least a 50% reduction in symptoms. With the tongue-like tissue, he estimated I’d have an 80% chance of getting at least a 50% reduction.

Given the fact that my wife and I are sexually active, I decided to go with the Urolift. With an understanding that it may not be effective, in which case I can decide to go with the TURP or another process.

2

If no one’s commenting, I guess this will become my Urolift diary.

Day 2:

The good is that there’s very little blood in my urine and it hardly hurts at all to pee. At times, the stream is great. It’s not consistent but when all systems are “go” I feel like a young man again. Went to the doctor for my post-op exam and the tech said I emptied my bladder well. 60 cc’s left in the tank. Recovery appears to be going fast and well so far.

The not-so-good is that I still have major urgency issues. After peeing, I still feel like I have to pee. The disruption in the region has my stomach on edge with sometimes a twinge of an unusual sort of nausea I’ve never before experienced. Last night, I was awake once an hour to urinate so I’m exhausted. But it’s only day two and I’m grateful. Looks like there’s a good chance I’ll have an excellent result.

3

It’s now morning of day 3. Last night was a bit challenging but easier than the first night. The first night was the hardest part so far, as I woke up every hour to pee and so didn’t get any deep sleep. Last night I woke up four times to pee, but the intervals kept lengthening. The first was about an hour and a half. The last was better than 2 hours. I woke up finally around 8, not having to pee for the first time since surgery, tired but not exhausted. I went to the bathroom and there was more blood than the night before, no doubt because I wasn’t drinking water through the night to dilute the urine. But there’s almost no pain or discomfort now. My bowels still get stirred when I urinate but not as much. And the burning sensation is pretty much gone.

4

@Parallax The reason my uro would NOT do Urolift for my BPH was because of tissue (Prostate) in front of bladder. Spoke of a ‘ball-value’ situation whereas voiding is interrupted. He said, the median lobe protrudes into the bladder neck. A surgeon has alot to think about cutting around, steaming, enucleation, lasers, and aquablation the prostate. The cystoscopy showed the flap (foss) over the urethra

5

I’m sorry, Carl. It’s a procedure that clearly doesn’t work for everyone. If you read my update, that I’m going to try to write this morning, you’ll see that I’ve run into challenges too. I hope your doctor finds (or found) a procedure that works well for you.

6

Day 3 evening and into Day 4:

Today, things got hard. Everything was great until approximate 8 p.m. when I had a strong urge to urinate and nothing came out. I had last gone at 5:30. The prior urgency that was forcing me to go every half hour or hour was gone so I hadn’t been concerned about the large gap. But when I needed to pee and couldn’t, I got really scared.

My wife got the urologist on the line. He said there was no immediate need to worry, that I could go to the ER if I’m in pain and need a catheter and, either way, he wanted to see me at his office at 9 this morning. He explained that it’s not possible to rupture one’s bladder and, though painful, not peeing for 16 hours wouldn’t be dangerous. But he recommended the ER to relieve my pain.

I managed to get a few drops out here and there. Took a hot shower because he said that sometimes guys can urinate with the warm water. Didn’t work. Just a few drops of blood.

Kept trying and getting just drops. Finally had to drive to the airport to pick up my son who was flying in for the holiday. Managed to get there and park. Tried the bathroom. I’m glad I was the only one in there because the pain was enormous and I couldn’t help make grunting noises as I tried and tried to pee. Again, just drops came out. Enough to relieve the immediate urge but a few minutes later the urge would return.

After my son arrived, I ran back into the airport to try once more and this time everything released with a huge clot of blood. Was fine after that until 6:30 this morning. Had gotten up every hour or so to urinate, which was a regression from the prior day. Had last gone around 5. Nothing came and this time no amount of straining resulted in more than a drop or two of blood. The discomfort was intense.

Went into the hot shower but got no relief. Struggled and struggled and then, about a half hour ago, everything released again with a huge clot of blood. So now I’m off to the urologist. I hope he figures out what’s going on and gets me back on track. Wish me well.

7

@Parallax Time will tell, hoping for you, that voiding gets easier. Question, do you know the number of implants your uro used? There would be a number for lateral lobes. Perhaps each side. Also, procedure promises to return home without catheter?

8

Thank you, Carl. In answer to your question, I was told there was a small chance I’d need a catheter. Ten percent or less.

The cystoscopy my urologist ran showed I had no median lobe and that I was probably a good candidate for the Urolift. Not a slam dunk (if anyone is) because of some weird tissue where my bladder meets my prostate. He’d never seen anything quite like it but could see no reason why it would be a problem.

I had four implants. I think of them as clips. He didn’t know how many I would need in advance so I found out when I came out of surgery.

9

Update: Saw my urologist this morning. He said that it’s unusual but not unheard of to have a great early recovery and then encounter a setback. When I got there, I was able to void. The sensation of needing to go was strong to the point of pain, even when I was empty. It’s been that way all day, which was the feeling of day one. The result was I pushed everything out of my bladder to the point that the tech couldn’t find the organ on the ultrasound.

That satisfied my doctor that there’s no immediate need for a catheter. He gave me two options. One, to put one in and live with it for a few days. The other, to drink a lot of water and see what happens, with an eye toward getting back in before his office closed at 4:30 if I ran into problems. I elected option two if he was willing to provide me with a supply of push-catheters for home-use in the event things go south after he’s gone for the day. He agreed.

So today I’ve been drinking liquids and resting and peeing. So far, I’ve had just one scare. For a bit my ability to urinate seemed frozen. But once my bladder filled more, everything passed and there was no obvious blood.

I asked the cause of the setback. He said there’s been bleeding and we know it’s coming from the prostate. That this can happen with no obvious cause in early stages of recovery. He compared it to a bloody nose. He said that if I drank a lot of fluid there was a good chance it would dilute the blood and I wouldn’t wind up with big clots blocking the urethra.

My sense is I got a little too cavalier when my early recovery was so ideal. I stopped drinking as frequently. Had as much fluid overall but wasn’t careful to space it throughout the day, which allowed blood to accumulate and clot. Also wasn’t quite careful enough to not exert myself. Felt so good, and it felt like I could be reasonably active. That might have upset my recovery and caused the bleeding. It doesn’t take much at this early stage when everything’s so raw and inflamed.

I’m a little nervous about tonight because I can’t drink while I sleep. But I’ll try to go to bed well hydrated, even though it will mean waking up frequently to pee. If that happens, I’ll be grateful.

10

Another update. Perhaps my last one, since not many seem to be interested.

It’s now been just over a week. Since the problems I encountered with clotting and the terror I experienced around not being able to urinate, I’ve been careful to follow doctors orders. I’ve not done anything strenuous (to minimize the likelihood of causing my prostate to bleed more) and I’ve been drinking a lot of fluid every day (throughout the day) to dilute any blood that is present.

The result is a slow recovery. Each day I feel a bit better than the day prior. Now, in day 8 following surgery, I feel pretty good. There’s still a bit of urgency. When I need to go, I need to go! After I pee, it takes five or so minutes for my system to reset. Until then, I feel like I still need to urinate even though I’m all peed out. But I’m otherwise comfortable. The stream exceeds my expectations going in. It feels completely unobstructed. I empty quickly and completely without effort.

Assuming things continue like this, before long all the urgency will be gone and the next big test will come when the doctor allows me to stop taking Flomax. Then I’ll know how effective this Urolift ultimately was.

11

just wondering how the recovery process is going. I am scheduled for Urolift Friday 2/25/22 at 230 pm. I spoke with my doctor about not being able to pee later that night, he has agreed to put catheter in while i am under and i can remove it 24 hours later at home. I am having done under deep sedation at surgery center. Good luck.
Pete

12

Sorry I didn’t get your message sooner. Hope your surgery went well. Came back to write an update about my recovery.

If things get challenging, be patient. I wound up getting a good result. During the recovery, I questioned whether I had chosen the right procedure. Wasn’t sure for the longest time. Now I’m feeling good about it.

Of course a lot will depend on how long the result stands the test of time.

13

I’m back to post another update. At this point it’s been 11 weeks since my procedure. My doctor had initially said there could be improvement for as long as 12 weeks. So I’m getting to the point where whatever I’m experiencing is likely to be as good as it gets.

I’ve gone through a lot of ups and downs during my recovery. At times it seemed like everything was going great and I was really optimistic. Then things would go sideways and I would feel pessimistic.

It’s been a while since I’ve experienced any post-operative pain or problems. I wrote about those earlier. By three weeks out I was feeling quite good and decided, on my own, to see what happened if I stopped taking Floxmax. The doctor had told me not to attempt this until the six week mark and my follow-up visit but I didn’t feel like waiting.

For the first couple of days everything seemed great and I was thrilled. More than anything, one of the results I wanted from this surgery was to be able to go off of both of the prostate meds. I was already off the Lisinopril. For me, that would be the ultimate litmus test, the dividing line between success or failure.

On my third day without Flomax, I suddenly found myself almost entirely unable to urinate. I went back on and didn’t say anything to my doc. After all, he had told me not to do go off early. So, when six weeks rolled around, and I went to meet with him, I was not optimistic that I’d be able to get off this med. He told me it was 50/50.

At the three day mark of this first sanctioned attempt to go med-free, things were definitely a bit more challenging. My urine stream was not as strong and if I waited after the initial urge, urination became quite challenging. Getting the stream to start and getting my bladder to empty was difficult.

I studied up online and found that there are strategies for those wanting to avoid treatment (medication or surgery). One was to urinate at the first modest urge. Another was to take deep breaths. Yet another was to go until the stream stopped, then wait thirty seconds and try again. As many times as necessary until nothing more comes out. Yet another was to sit when urinating.

I tried all of them with degrees of success except for sitting while urinating. That didn’t seem to accomplish anything other than making it difficult to know how well things were going because I couldn’t see what was coming out. I found that, with these strategies, I could get by.

Then slowly over the last five weeks, things have continued to improve. Not enormously. I think it’s fair to say that by six weeks post-op, I’d gotten 90% of the improvements I would get. But the remaining 10% can be a big deal when you’re right on the edge between the result you were hoping for and the one you wanted to avoid.

At this point, I don’t feel that I’ll have to go back on the Flomax anytime soon. Of course, my prostate may continue to grow so it’s possible I’ll need it again or a TURP at some point. But for now I’m good. I still have to be careful not to hold it too long after the urge to urinate comes. But I can hold it for five minutes or so without adverse effects. If I go longer, it’s not that big a deal. It takes longer to empty and I may have to try again in 20 minutes but not the end of the world. As long as I don’t put it off, the stream is quite good. I’m not saying I’m peeing like a racehorse, but probably as well as I did in my late thirties.

This is a result that makes me happy and grateful. The remaining test will be the one of time. How long before I find myself needing additional help. So I’ll report myself as very happy for now with the caveat that I won’t be satisfied if I’m back on meds within ten years or if I find myself later on needing a TURP. I know those are likely outcomes so I’ll report myself very satisfied for now.

14

Thanks for your detailed diary. This procedure is an option for me but I am disappointed that you have not found it to be as simple and effective as it is portrayed. Please continue to keep us updated on your progress.

15

thanks for your diary it looks like we had our uralifts about the same time, and our experiences were similar, although i did not have any clots i did have quite a lot of discomfort. I’m still taking tamsulosin but am just about to stop. in going to take it every other day to start with and will report how i get on.

16

Parallax, Thank you for all of your personal updates. I too just went through the Urolift procedure four days ago. Although I was able to leave the hospital without a catheter, I have continued to have clots in my urine. So far, none have created a immediate problem. I am 63 years old and in better than average shape although I am now questioning whether the Urolift procedure was a good idea. It appears the only great reviews are from the manufacturers and urologists. I have visited a number of blogs from Urolift patients, and 99.9% seem to tell a story of less than favorable results. At $14k per procedure, this might end up being weighted heavily toward the benefit of the doctor versus the patient. Time will tell.

17

Hi all, New to this site but very interested in everyone’s experience .
I guess you could say i am now somewhat of an old hand at this.
My story in short. Suffering BPH for 10years. Tried all the drugs ( not for me) Had first urolift in 2016 . 5 x implants . Reasonable success . Flow was better and hesitancy better. This lasted a few years and things started getting progressively worse and back to where i started. ie hesitancy, frequency ( blah blah you guys know all the symptoms).
I never got to the stage of retention although i think i was close a few times.
Anyway, i had to act, I am only 62 and in pretty good shape. Very active lifestyle and everything still functions well. My dilemma was what to do next. Researched and researched and then researched again. All the options , reading all the google stories etc. Looked at PAE seriously .
Went back to my urologist who did the uroloift ( and now doesn’t) and we looked at rezum as this is now the "non invasive "treatment he now offers. He tried to steer me away and suggested the only way i would get 100% relief would be a TURP. My biggest fear was preservation of sexual function in all areas. Something he could not guarantee with eithe method ( although the rezum has a better chance than turp at preservation i believe )
Anyway, I kept searching the internet and reading stories ( mostly horror) about Urolift, Rezum, TURP , Greenlight etc.
I might add at this stage my prostate is about 90cc with a moderate median lobe and is considered Grade 3/4 enlargement ( basically meaning there is hardly any clearance) .
So continuing on , i came across a blog from a guy from England , a bit older than me but basically in the same position with similar symptoms except he had tried PAE first, the Urolift.
He discovered that Urolift had been updated to Urolift 2 and the treatment of a median lobe was better.
He opted for a second treatment and by all accounts was the best thing he has ever done.
I was keen to go back down this track as I had no complications from the first treatment and most importantly sexual preservation.
To shorten this up as i have to go , I tracked down the Associate Professor in Australia that developed this method and we had a discussion via zoom.
He gave me the confidence to go ahead so i bit the bullet and went again.
OK , So today I am 10 days post OP. All the normal issues for the first 4 -5 days. But right now i am one happy man. I am peeing like i was at 30 , have a little bit of urgency but its early days.
Im not on any drugs .I feel great ,and ready to go back to work.
The only thing i did develop was 2 x DVTs in one leg , but on meds for that now.
I truly hope i get at least 5 good years with this, ill be very happy.

18

I hope you and me both get five good years. Thanks for posting.

19

I’m back to post another update. I appear to be one of the lucky men who has had a good experience with the Urolift. For a while, I wasn’t sure if it was the right move but now, looking back from a distance of four months, I can say that I think it was.

I’m writing again to report that I continue to have improvement long after my urologist said I would not. He had said I’d get 90% of the benefit in the first 6 weeks and then could see continued improvement out to week 12. That was mostly true but I’m continuing to see incremental change in two areas.

The first is easiest to explain. Having gone off my prostate meds, my libido is returning. I’m pretty sure it was the Proscar that caused the issue. So glad to be done with it. I said when this began that I’d be satisfied if I could get off both the Proscar and the Flomax. I was able to do so. At first, the stream was weak but passable. The second improvement that’s harder to explain is that, four months out, my stream still appears to be slowly getting better. Today, for the first time in years, I felt my bladder as I was urinating after enough had been eliminated to take away any pain. It’s been years since I felt my bladder contract like that. I can only imagine that the musculature of the bladder, having built up to deal with obstruction, is now reducing because it’s no longer needed. As a result, some feeling in the bladder walls is starting to return. This exceeds my expectations.

I don’t expect to get to a point where I pee like an 18 year old but there are times when I feel like I could be 35. (In fact, I’m 59 and have had prostate issues since my late 30s.) Sometimes the stream is still very slow and the urine is slow to start. Sooner or later it comes but I have to be patient. Most of the time, to fully empty my bladder, I need to restart after the first stream has ended. But it’s all become rather routine and I find that if I go to the bathroom as soon as I feel the urge (or reasonably soon after), everything tends to come out easily and with a decent flow. Not like a 20 year old but more than good enough.

On the sexual side of things, I had been at a place where I could go months without and it wasn’t an issue. Now, I recently suggested to my wife that twice a week would be ideal for me and that, absent that, I need to masturbate. She and I both prefer to focus all of our sexual energy within the relationship. She’s game on twice a week. In fact she said it’s perfect for her in her perimenopause state (she’s 48), provided she can get adequate sleep and set aside the time. We have a seven year old son with type one diabetes. Between the fact that we both work and she spends a lot of her day caring for him, plus as I’ve gotten older it takes me longer to climax, it’s not easy to find adequate time alone. But none of that is relevant to this discussion. I share it in case it’s helpful to others. The main point is that I’m feeling like a sexual human being again after having gotten pretty well shut down by Proscar for the last several years. What a relief it is to be done with it.

20

wanted to say Thank You for all your posts, I just had the Urolift this past Weds 5/4/22 and its been a hard recovery for me so far, basically every 10-15 minutes I feel like I have to pee and most times big clots are flying out so Ive taken to sitting, and that helps, but when I stand up I pretty much have to go again and blood dribbles out, I had 4 clamps put in which the doctor said is pretty normal, what I find strange is that on day 2 I had basically no clots or blood and my urine was yellow but today day 3 its all blood and clots again.