I've been told that I require surgery to improve flow through my prostate and hospital have recommended TERP but it is evasive and I believe it has lots of side affects so I am looking for anyone who has positive or negative experience and whether anyone has any experience of more non evasive form of treatment like PAE
Did you mean TURP? If so you will get mostly negative reactions.
Whatever do you mean by evasive... Is the urologist crossing the street when he sees you, or not returning your calls, so you can't book a TURP?!
Hi Micky,
Welcome to the forum.
Yes, TURP is one of the more invasive surgeries for BPH. Some men are happy with it, some aren't. You have to know that there is a very high incidence of permanent retrograde ejaculation which is a dry ejaculation where no semen comes out. This bothers some men, others it doesn't.
My suggestion is to take your time here and elsewhere exploring all the options. One thing I've found here is that people who have had success with a given procedure will generally recommend it to everyone. And those who haven't had success with a procedure will not. That is the limitation of anecdotal accounts and forums like this. The truth is that all of the procedures, including TURP, have had very good results and not so very good results. Its then really up to you to figure out the pro's and cons of each approach. You mentioned PAE for example. Some people rave about it and some regret they have had it.
One factor often not mentioned here is the previous condition of the bladder prior to the procedure. This can effect results dramatically. If your bladder is in very bad shape, none the procedures will help much. If it's in very good shape, most of them will help. That's why testing prior to any procedure is important. In addition to the usual DRE and cystoscopy, you will want a bladder/kidney ultrasound study and probably urodynamic testing. The latter is more than visual or image analysis, but functional testing.
Lastly, many here, and I include myself, have chosen a watchful waiting strategy. The idea here is that all surgeries have risks and potential side effects, so why rush into it when there are less invasive options available and newer and possibly better procedures are down the road. Meds like Flomax are one route. Self catherization (CIC) is another route, one which I have taken. I chose it because it protects my bladder and kidneys as well as any surgery without the risks and side effects of any of the current procedures.
Whatever you do, take your time making a decision and don't get swayed by someone's individual experience here, because that's all it is, an individual experience. If you carefully read through all of the threads you will read that someone has posted that each and every procedure was "life changing". And you will also read that each and every procedure didn't work. Same procedure, often with the same doctor. The key is that the patient was different and their condition was different.
All the best with your choice.
Jim
Most urologists are quick to book a TURP. It's afterwards they may become evasive. At least that was my experience.
Depends on how much the potential sides matter to you. If youve not heard of REZUM look it up. Do TURPS as an absolute last resort. There are lots of guys on here who have had it done.
Shiver at the thoughts of self Catheter
@David: Shiver at the thoughts of self Catheter
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And I shiver at the thought of getting some of the permanent side effects that can happen with any procedure. FWIW no one was more squeamish about self cathing (CIC) than myself in the beginning. All I will say is that once the body gets used to it, usually within a couple of weeks, it can be about as traumatic as brushing your teeth. CIC has served myself and others here well. Its unfortunate here that men let their emotions and possibly a bad initial experience interfere with something that can save them from a surgery.
Jim
I did a few self catherizations out of necessity after a procedure caused some acute retention events. You use a very slender sterile flexible tubing that you gently insert. Once it reaches the bladder, you can fully empty the bladder. It was not really painful to me, and the relief it gave me from a screaming overfilled bladder was like heaven at the time. All of the things you ask about have already been discussed at length on Patient. Just do a search in the forum under "Prostate" to find out about different issues.
Glenn
My soon to be former urologist wanted to book a turp right after he screwed up a routine biopsy. I did not know this for sure until another doctor let something slip. He did quite the sales pitch and the wife in law being german (they are putty in the hands of a salesman) was all ready to do it. After the biopsy I went into full retention (can't pee) and got a catheter three times. Thanks to this website which I had plenty of time to find and read because of the catheters and bags I learned that a Turp is probably the last resort. It used to be the gold standard. (well the only standard).
I asked my GP for a recommendation for a doctor in Sydney to investigate a Prostatic Arterial Embolization PAE. He did not know what it was. For the last five years or so Radiologist have been putting little balls in the arteries leading to the prostate. For those with a really large prostate it has been very helpful. It is an old procedure used in other areas for the last twenty years or so.
When I asked my Urologist about the procedure he said my 180 cm prostate was too big! He was completely wrong! The doctor in Sydney did one that was about 670 cm.
I am off to liverpool to see one of the urologists that has been tamed by the PAE guy. He wants to make absolutely sure that the procedure will go well. Dr Schlapoff actually called me! Unlike the Urologist who had his secretary tell me to go to the ER and get a catheter installed.
So if your urologist is being evasive before cutting on you I would have a think and read everything on this site.
You can put me down as having a negative experience with just a biopsy.
Hi Derek
Apologies for my misspelling it s TURP this I refer to as I am in hospital at moment with Sepsis and the doctors are pushing for me to have the surgery whilst I am in the say it is causing the sepsis so I looked to this forum for help and support and appreciate your comment. The doctors have been evasive every time I challenge TURP or ask about other options and none of the medications work.
Many thanks for your comments Glen
Like the witty humourous comment Paul brought a sense of laughter as I lay in hospital recovering from my latest bout of sepsis
Hi Jimjames
Many thanks for your comprehensive response and valued feedback on this issue. You have highlighted many things I wasn't aware of which have already armed me with the next steps I need to take with my consultant. I am in hospital at the moment with my fourth bout of sepsis and the surgeon wants to carry out the TURP procedure whilst I am in hospital to prevent more infections so you have helped with my decision and this is the reason why I have joined the forum I guess the answer as you say is take time and not be pushed many thanks
Micky. Look into something else. My urologist feel the turp is a last resort procedure. there are many others you can do that will do the same . UROLIFT, FLA, PAE and REZUM. Don't take the first thing they offer. They all to the same make a tunnel. Or if you don't want surgery Do CIC it can help and stop you from having surgery Good luck Ken
Wishing you a speedy recovery from sepsis. It has been much in the news in the UK recently.
Can they operate while you have sepsis??
The fact that you've had four bouts of sepsis is crucial, especially if your doctors believe that a chronic bladder infection, caused by urinary retention, is the root cause of the sepsis. If that is the case, delaying surgery for long may not be advised, especially if medial experts believe it could help with your infection. While sexual function may be important to an individual, stacked up against (for example) the possibility of kidney failure from chronic infection, you may come up with a different answer.
Glenn
They are evasive before and after. They will only tell you what they want you to know, not what they don't want you to know. They don't want to lose you to another procedure because TURP has no insurance problems and is good money for them. It is only during a bad recovery period that patients start complaining on this forum.
I agree with Glenn in that if your recurrent bouts of Sepsis are being caused by retention, then you need to do something very soon. That said, if all that they are offering is TURP, and if you want more time to explore other options, then think about self cathing as at least an interim measure to buy time. Self cathing will empty your bladder completely so there will be no retention, thereby protecting both bladder and kidneys.
Jim
Micky I had sepsis in 2014 had 8 infection kidney and bladder. My white blood count was over 25.000. Do not let them do any surgery until your healed from the sepsis. Turp is the only thing this doctor must know. How about getting you well first Try to holed off and look into something else. I was on IV for 6 day in the hospital and went home with a port for another 11 treatment. Please do yourself a favor tell him no. If you don't I think your looking for more trouble. My sepsis was in my whole body and the blood. The doctor told me that if I would have waited a week I would have die. My doctor got me well. Not lets take out your prostate to see if it help. God bless Ken