To all my fellow Men. I'm a persons that likes to have all the information and facts before anything happens. I like to be prepared and I don't like surprises. I have information on anything I have had done and have looked up thing for many men on here. Also got information from my Urologist. This post is on Bladder Stones. Did you know if you have bladder stones. They will remove them with a procedure called Transurethral Cystolitholalapaxy where they go into the bladder and break them up but do you also know that if you have this done they will do a turp on you. I found this out looking up information on a trail that they were doing. The youngest man was 36 and the oldest man was 93. I'm very sorry but what man at any age want to get retro or incontinece. To me it seam like the doctors are treating one problem and then giving you other problems. Which will cost you more money. If I end up with bladder stones I would go for Suprapubic Cystolitholapaxy or a Open Cystolitholapaxy. It may be more invasive but my prostate will not be touch. I know it may be a little out there but I at 61 I still enjoy sex and all of it fumctions. Some men can deal with the side effects but some men can't and give up sex all together. That is not fare to us men. I think that urologist forget that they are men and what they doing to other men in some of these procedures. Also I found some facts. With Turps or any of the procedures that cut away at the prostate there is a 25% chance of Erectile Dysfunction plus if you are on medication like Doxazosin you add 3% additional and with Finasteride you add 22% additional. So if you are considering a Turp when you add all this up it is a 50% chance of having a problem with having Erectile Dysfunction. So gentlemen before you have any thing done make sure you get all the informaion you can either on the internet or by your doctor and if he does not want to answer you question . It's time to get another doctor that will. Also talk with a buddy. Years ago men never talk about male problem. I am very up front with my sons and my friends I have 1 friend that is 50 he made the wrong decision and now he has to deal with it. He is so depressed that he whats to die. We talk alot. If they have a question I will answer it. If I don't know it I will find it for them. Life is to short to add more problem with evething else in this world. Let's enjoy it and have fun. Good Bless you all.......Ken
Thanks Ken
Good information to have. There are better ways to treat a lot of these issues that men face these days. Men need to be better informed on side effects of each option available. We need insurance to start thinking about what is best for the patient and not how they can make a bigger profit. We need society to start caring as much about men's health issues as they do about women's health issues.
Hello Ken,
I see many of your posts so I know that you follow many of the guys story's and have been able to compile a lot of info so perhaps you could weigh in on this.
I am post Urolift about 14 months and feel that I am pretty much where I was when I started, however if I had not had it done perhaps I currently would be worse off.
When I void it is rarely over 200 cc. Often immediately after voiding I use the good Ol Speedycath and remove consistently 400 cc. I normally only self cath before bed and sometimes when I get up but I am not 100% consistent with this. But each time it is 400-450 retention. I take Tamsulosin daily with intermittent breaks for a couple days at a time, I know the Tamsulosin suppresses my sex drive as well as quantity of semen during orgasams.
I guess my question to you is, in your opinion, does a PAE sound like possibly my next step?
I was referred to San Francisco State University by my Urologist a couple months ago and after a short discussion with the doctor there he told me that all he could offer me was a TURP, and I said that's it? No other options and he's said yep, that's it. So I left. Kind of sucked because I waited 2 months for the appt. and then had a 2 hour drive and was still almost late for a 15 minute appointment..
I also just read a post by 333 (?) where he has had great success, but I do hear some storied that make me want to steer clear.
I just don't want to have to depend on CC indefiently, and not so sure that it is not harming my prostate.
Anyways Good Day Ken, will be looking towards your reply.
Anthony.
Kenneth, as I wrote today I had TURP on prostate less than 2 weeks ago. My doc said retrograde ejaculation was a given but erectile dysfunction due to TURP and urinery incontinence were NOT, unless the surgeon was doing it wrong. He is a vastly experienced surgeon though I wish he would communicate more with me regarding the post operative issues I am facing.
HoLEP gives RE in about 7 cases in 10 and should be better than TURP on that count (and also for bleeding problems). The general perception is HoLEP may be the best option for PROSTATE IF the surgeon is an expert with his laser gun.
Hope you can collate these info for your stone and prostate problems.
Hi Sandip,
Please tell us your condition at this stage (2 weeks after surgery) and what surprises you are running into?
I am scheduled for surgery, and Uro will do a laser TURP, vaporizing prostate tissues on touch. He says it is better than Green light laser since that has a wider beam and difficult to point on tissues exactly.
Aah, that's a different kettle of fish, NK. Sounds like HoLEP (Holmium Laser Enucleation) which does vaporise tissues. Biopsies may be difficult however.
As my surgeon explained while I was watching the operation on the monitor, he was both cutting the tissues with a hot circular cutter which also could scrape to level, and seal the wounds by heat. It was quite exciting. But there were hundreds of cutting of tissues and they had to flushed out by irrigation. For large prostrates, more cuttings and it is unlikely that they will go away in a day or two.
You may ask your surgeon these:
a) chances of prolonged urinary incontinence;
b) erectile dysfunction;
c) retrograde ejaculation (dry climax);
d) duration of bleeding, if any;
e) chances of injury by laser to other areas;
f) how the biopsy will be conducted.
As for me, it is downright irritating to see urine clear for a few hours and the blood and clots coming back with a murderous color. But mine was not laser, it was plain cut and cauterise and those nuissance cuttings to boot.
My gut tells me you are opting for a better procedure. Ask your surgeon all you want to, make up your mind and just go for it. Good luck!
I am replying to your post as I am about eleven veeks post op after what is officially called Laser Enucliation of the Prostate with Morcilation. The laser most reffered to is Holmium hence HoLEP. The laser used in my procedure was Thulium hence THuLEP. The morcilation process is usually at the end and its purpose is to "chew" up tissue and remove it for lab work. The process is similar to TURP except that the prostate is completely hollowed out leaving only the "capsule" or shell. There is little to no chance of having to do this again. Green light has from what I have gathered a horrible reputation so stay clear of that. I am very happy with my outcome thus far with just a small amt of dribbling and expect that to end in time. Sexual effects are nill, no ED and yes Retro is a given since there is not much left of the Prostate when done correctly. Main consideration is the surgeon. HE/SHE must have aquired much experience in this as it is difficult to master so this is an important question for for your Dr. Like "how many procedures like this have you performed?" "what has been the outcome with regard to ED and incontinence?" If you have any questions that you think I can help with just post.
Ken, I had bladder stones around three years ago. How I found that out was that I was urinating blood. That was a scare in itself! My uro, went in and removed the stones, by breaking it up with a laser, I presume then sucking it out. He asked me if I wanted to also do a turp, since he was in there, and I told him, not at that time. He didn't automatically do it...he asked permission first.
Hello Anthony. Sorry to hear that your having a little more problems. When you had your Uro-lift done how many implants did you have put in.. I had 4 implants done April of 2015 it has been working fine. I did have 1 problem I got a prostate infection from 1 of the implate letting loose. When I had the repair done he had to tighten all of them when he put the new one in. He does not know why my prostate got smaller. He thinks it may have something to do being on ciprofloxacin 1000mg for a month. I don't care it good for me. Just had it checked and all is fine PSA is 0.7 Now getng back. You may need to have more implates Have you ever seen a guy on here ChuckP He had it done right after I had mine it did not work for him Had to have 4 more put he. Now he pee's like a teen. Talk with the doctor that did yours and see if he can put a few more in. It's a lot less down time PAE is great for alot of men it works well. PAE can take up to 3 month's to get full benefits. Don't let any doctor tell you that a turp is the only way it will help you there is allway something else you can try. A turp has to many side effects. ( If you walk into a urologist office and he is a add for the turp procedure just turn around and leave ) I am very lucky I have the urologist I have he will not do a turp unless there is no other way and he does not do anything unless you are happy with the choise you mak. His main concern is his patient. If you like to chat e-mail me anytime Ken
Men need to get the information on any procedure that they are looking to have and don't be rushed into them. Alot of the urologist will suger coat any procedure that he is trying to get you to have. Yes there is less blood when they do the lasser but all the side effects are still there. For me I will never have any procedure that will cause me retro or any other problem. I'm not giving up anything. It is my life not there's.and I would have to deal with the side effects And yes a good surgeon is the key but I am not going to be one of unlucky few. . Take care and I hope you are happy with your procedure Ken
That is very good to hear. This was trial that I read and I guess they did it both way. . I just got a email on this from my Urologist. Was suprise it sunday. He told me that it is normal to have both done but if the patients tells the doctor NO they will not do it. So the key here is to make sure you tell your doctor no and not wake up and have a surprise. Take care and Thank you Ken
Thank you for the information. Many more such comments are needed.
No problem. I just try to keep men informed We need to stick together..Ken
Hi Sandip,
I am puzzled. Why did you go for TURP (with cutter)? I thought these days it's done with Lasers.
Secondly, is Biopsy a concern if my PSA level is normal?
Hello Ken, My Uro doc said he put in 5 implants, all I can do is believe him. I felt like I was headed in the right direction when he referred me to a university level Uro. Which I was very displeased with. No TURP for me, I have read enough to know better. I would like to perhaps find another Uro doc who has done more Urolifts and who would feel veery confident with putting in more devices. I live near Modesto Ca. And was traveling down to Fresno which is about 100 miles. However the last 5-7 trips down there all we did was talk. I did request a cystoscopy so he could actually take a look around to see if he can see anything out of whack, what I got was a tour of my prostate and bladder, I could not even tell you if I have a "medium lobe"??
The Cysto was only 8 mos. after the Urolift and I did not see any of the clips, my doc said they have already embedded themselves into the flesh and are not visible. Perhaps one of followers of this blog site knows of a good doc somewhere near my location.
Thank you for the feedback, Warm regards and have a great day!
Anthony.
I wish you were near me My urologist would take care of you. Look on the urolift site and see if they have any doctors in your area. Chuck had 8 put on his. I just had a scope done on friday my doctor said that my implants are in the same place were he put them in march. I will see if I can find a doctor in you area I have some time today Sons at work my myself. I will let you know..Ken
Hi, Ken,
Thanks for starting this thread. As you may remember I have bladder stones, and I opted to go with PAE for my BPH. My radiologist wanted the stones removed before he did the PAE.
When I talked to my urologist about removing the stones, he expressed concern about my large median lobe pressing into the wall of my bladder. He said that could cause complications when he pushes his equipment in to remove the stones. He said there could be excessive bleeding, and if there was, he would do an emergency partial TURP.
I wasn't comfortable with that possibility so I talked it over with my radiologist. We decided to do the PAE first, thinking that my prostate will shrink and pull away from my bladder, making stone extraction easier. I'm now about 9 weeks out from my PAE, and the PAE has been working. I can now urinate some on my own--I'm peeing weak streams with greater frequency. Four uros told me I'd never pee on my own again and discouraged me from PAE.
When I'm 4 months out from my PAE, I will need to take action on my bladder stones--at 4 months most of my prostate shrinkage will have occured. I certainly don't want a urologist messing up the progress I've made with PAE! I will be seeking opinions from other urologists about this--and reading this forum!
Stebrunner
Hey Kenneth,
Thanks for the information. Before I had my P.A.E. in June of this year, I was on both Finesteride and Tamsulosin. My doctor told me nothing about these drugs in advance of thaking them and acted as if it was like taking asprin. As a result of the Tamsulosin, I now have retro-grade ejaculation, two months after my P.A.E. I've changed Urologists and the new guy tells me the retro should be gone in another month or so. So that's four months with retro and, again, there are no guarantees.
In you'r studies, have you any definitive information regarding this 'fun' part of BPH/PAE? I've been doing reading on the sujbect but not getting anywhere.
Thanks again for your input. All the best
That's "medial lobe," Anthony. FOr reasons I don't recall, guys with medial lobes can't receive the Urolift. Dr. Steve Ganges in Salt Lake City has done hundreds of Urolifts and did mine. Although I live iN PA, I chose him because he did the trials for Urolift before the FDA okayed the procedure.
My situation was problematic because of the SMALL size of my prostate (38g), but we chanced the procedure in December. It was IMMEDIATELY SUCCESSFUL, I peed like the proverbial teenager. I stopped the Tamusil and the other one (didn't like side effects and Doc okayed it), but the pee stream gradually lessened. I usually pee 50cc to a max of 150cc or so...Because of my permanently-stretched-out bladder, I never completely void, and on advise of my doc I cath midday and before bed. I "listen" to my bladder, and if I get the news that it's full, I cath at other times, when peeing doesn't come naturally. At those times I usually cath 400-600cc...
The reason is I live in India
The HoLEP and similar procedures are here but I was just not sure HOW good the surgeons were with the laser - in short, the numbers of patients they have operated on. I asked my surgeon all I thought was necessary and he duly replied, but the possibility of seemingly endless bleeding didn't cross my mind and the surgeon didn't forewarn me of that-unfair. Had I known this I wouldn't have gone for conventional TURP, the "Gold" standard of the yesteryears.