Long Urolift recap - 8 days in

I’m not sure if this should be a new post or part of the 80 page Urolift thread. That one seems to have gone so long, with so many very old posts, that I think this is better as a new thread. If the moderators disagree, I’m fine with it being merged into the other thread.

I had a Urolift done 8 days ago. I wish I had found this board before I had it done, as there is so much more info in the various threads here than all the reading I did before the procedure. Sadly, this site never popped up during routine searches, but was near the top of the search results when I search for specific side effects I was now having. Like some others have said, I feel like my doc undersold the negatives and the recovery pain. I’ll hold off on deciding whether he oversold the positives until I have given it some more time. So, I will add my story to assist anyone else who comes here looking for info. I’m going to give more detail than I see in some other posts because I want this to be something I would have wanted to read before I went forward.

I recently turned 60 and have steadily developed issues fully emptying my bladder. Start/stop, split stream, and having to pee 15 minutes after I already peed. I figured I could live like that for a while longer but a friend a bit older than me apparently had similar issues and his doc told him his bladder had suffered some damage from the condition. So, I made it a priority to see a uro for the first time in my life. I am otherwise generally healthy and in otherwise very good shape, exercising daily, so I normally only see a primary for an annual exam.

The doc calculated my AUA score to be 24, which is in the severe category. My number comes out a little less when I answer the questions online, so I must have answered more aggressively when filling out the paper at the office. The doc gave me the urolift brochure and told me how it was a great answer for someone my age, since it didn’t have any of the nasty side effects of the other options, including RE and that most men do not need to leave with a catheter. I knew the basics from prior research but the doc’s additional explanation of how it’s done was helpful in deciding to go forward and get the follow up tests to see if I was a candidate for the procedure.

My prostate measured to 40 and cystoscopy showed a closed channel, with a median lobe also present. The doc explained that the median bar lowered the positive outlook for a Urolift from 90% to 85%, as it complicates things but they put in the clips in such a way to pull it away from the bladder neck. I went home and researched it and came across the Medlift studies, which showed that Urolift was still a good procedure with this condition. So I went ahead and scheduled it.

I had it done in a surgery center, which is the only way my doc does it. The check in nurse told me there was a 50% chance of having a catheter when I woke up, which I told her was not what the doctor had said. He happened to be nearby so he came over to explain that if there is a lot of blood oozing, he uses the cath. He had already done 3 that morning with only one needing a cath so he hoped I wouldn’t need one but it all depended on the results. Sadly, I awoke after the procedure with a cath inserted. I didn’t even have time to register the disappointment as it was incredibly painful, with intense levels of pressure and burning. The pain literally caused me to shake and they put a shot into my IV to help. The shot took the edge off the pain but the pain was still very bad and I told the nurse that there was no way I could leave the facility while in that pain. The doc eventually came out from a surgery and advised it was there to avoid a blockage due to blood clots. He said it wasn’t absolutely necessary to keep it in but that I risked having to go to the emergency room if I did develop a blockage. The nurse took it out and I felt a world better. I asked for a something to pee in and I peed about 6 ounces with a fair number of clots. We discussed the emergency room again and they let me go home.

Once home about 1:00, I had to pee every half hour to an hour for a while. I passed my last clot at 3:00 and had very light pink to clear urine the rest of the day. I woke up 6 times during the night to pee. I am 3 to 4 times now. Oddly, I peed out one more clot on day 5 and now start most pees with a little bit of pink before it runs yellow or clear.

The first few days, my pelvic area was sore, and it felt like someone was squeezing something inside with pliers. I guess that is the result of the procedure compressing the prostate tissue. That makes perfect sense but I was not warned that the prostate could feel like that.

It hurt like hell to pee for several days, and still hurts today. Whenever I pee, the front part of my penis feels like I am passing broken glass or having needles shoved in there. And my prostate burns as the urine goes through. It takes a good 5 minutes for each of those feelings to subside. I took some AZO but it didn’t help. By the end of the week, I was able to go anywhere from 2 to 3 hours between pees, which is where I am now. I sometimes have a good flow and sometimes it is a very weak stream or even almost a dribble, which is worse than before the procedure. The doc said I won’t see the benefits of Urolift for 2 weeks, but I did not expect to have times with such a weak stream now.

There are a couple of things I am dealing with that I had not seen mentioned in some of the other threads, and I want to add them here to see if other people deal with the same thing. First, the burning in the prostate after peeing triggers a need to have a bowel movement, even if I don’t really have much there to get out. So, I go more than I normally would and sometimes just pass some gas but that eases the feeling that was triggered.

Also, I have a lot more difficulty peeing while sitting down. I feel it more in the prostate and it doesn’t seem like it wants to open up in that position. I guess it is either the angle of the various parts or something like that that is making it difficult.

So, that is the long story of where I am, 8 days into the process. I am hoping for dramatic improvement from here. As of right now, I am sorry I did this, but I will keep an open mind and post updates as the time goes on. I am hoping I am even half as happy as Ken is with his procedure once the recovery is complete.

FWIW, my friend that I referred to above had a HOLAP and he has not had a bit of discomfort since they took out his catheter after 2 days. He said he pees like 30 years ago. He does have RE, which he has decided is acceptable in light of his results. So, my view on Urolift will be colored by how happy he is with his procedure.

Feel free to ask any questions you may have about any of this. I appreciate what I have learned from reading other posts and I’m happy to contribute.

Hey Buddy

This is Ken Just give it some time. I had the catheter in for 3 days. Remember the prostate is swollen and you will be like that for a few more day. When I had mine over 7 years ago there was not much on the Urolift. I also had the burning when peeing. The blood clots I passed a lot before I was getting dressed. I went home with a catheter. This was the first time I had one. Was not a fan but got use it it. I had a bag for nights and one for y legs during the day.

You will be fine. I also had the burning for 3 days after the catheter came out but I was good to go in a week. You may have to do a little more time because you had a small median lobe but you never know we all heal different. No doctor can tell you everything. Because they really don’t know.

I have a friend that had the Holep do he had a very big prostate. The doctor took out 55 mg from a 135 mg in size he also has retro but he also had to have a catheter put in twice because he could not pee. He is doing great now. That was 2 years ago.

God bless and be safe…Ken

Thanks Ken.

I have to say that the burning and pain during the pee is not as bad as the 5 minute afterburn. I am a bit ticked at my doctor because I called Friday morning to see what he thought about it and whether I should be taking an antibiotic or something to help but never got a call back from him or his assistant. I have really liked him except for this.

I have had a catheter once before, after a surgery 25 years ago. It was in for a day and a half, in the hospital and it was a bit uncomfortable but not painful like the recent one. I am not sure of the size of that one but the recent one was a 16. I am guessing that the older one was smaller because it was just there for urine, not blood.

I’m going to keep my fingers crossed and hope that mine ends up like yours when all is said and done. I will post an update on my status in a week or so.

No Problem It will be okay.

The only thing I hated was the spasms when the catheter was in. I had a 14 fr catheter because I had a stricture. I have a very good doctor. Been with him for 8 years.

Take it easy…Ken

Dear B: Thanks for your story. I am 25 days post, and at this point I can only say that it’s interesting so far. I think I’m lucky in that the procedure itself was easier than I thought it would be. It took about a week to be able to get around, drive, go walking. I did alot of icing the first few days - and I recommend it. I iced my pubic bone, my tail bone, and my perineum. I think that gave me relief and eased the inflammation. At just past the 3 week point, I can say that when I pee I feel empty which is a good sign. But I have to pee almost every time I stand up depending on how much liquid I drink. So that’s annoying and I’m guessing that my bladder, urethra, and sphincters are all teaching each other how to work together all over again. It’s like toilet training. I’ve been experimenting with holding the urine for awhile and doing Kegel exercises to strengthen the sphincters, but I’m not holding for too long because I can’t. Again, after I pee I feel empty, which is something I never felt before the Urolift. As of now, the discomfort in my groin is completely gone unless I get an erection. When that happens, I feel pressure in the groin. I had my first orgasm two nights ago and it hurt like hell. So I guess that’s out for awhile. I won’t try it again for at least another three weeks depending on how the bladder control goes. So far I’m glad I did the Urolift. But the jury is still out. I went off the Flomax a week ago - at first my stream got weaker, but now it’s going better than it has in many years. I’d be interested in hearing from other guys who are just days and weeks post procedure.

Anthony,

Thanks for the input. Your comment about having to pee every time you get up made me laugh, since I had been that same way until 2 days ago. I have told my wife that I was avoiding getting up for certain things because I didn’t want to have to pee. I’ve seen improvement on that the last 2 days and was able to wait 5 hours between pees today. Even small victories are appreciated. I hope to progress to where you are with improvement in the stream and feeling empty. As of right now, I just want the burning to go away during and after.

I have not been taking any Flomax, which I have read that a lot of people are doing to relax the muscles in the area. I tried Flomax for 6 months about 2 years ago and it did nothing for me.

Good luck with the orgasm situation. If I have similar issues when I get to that point, I am really going to be unhappy. When the doctor told my wife and I not to have sex for 2 weeks, I thought that would be difficult. A couple of days in, though, I told her that I couldn’t even imagine trying before the 2 weeks ran.

16 days post procedure. I am still in recovery mode. Some days it feels like I am almost fully recovered and then I am back to some discomfort. The pain while peeing is much less and sometimes there is no pain at all, but I still have the afterburn as soon as I am done and that lasts a few minutes.

I started working out again and this is mostly okay. Jumping or running causes a burn in the prostate and a feeling like I have to pee urgently, even though I don’t really need to. I assume that is a result of the bladder bouncing around inside and irritating the prostate. Another symptom that I am hoping passes quickly because I need the calorie burning workouts.

The 2 weeks ran on the doc’s no sex guidance so my wife and I gave it a shot. I was a bit nervous about it due to the pain that Anthony mentioned in his post, but I wanted to know what it would be like before my post op appointment this week. Everything worked but the orgasm was indeed painful. I will have to wait a while to give it another go.

7 weeks post procedure. Pain all gone, although I can sometimes feel the prostate when I run. So, there is still some sensitivity there.

I am pretty much back to my pre-procedure peeing routine. I go on average every 2 hours, with 4 hour being the longest interval. I still get up 2 times a night to pee. While it’s frustrating to need to pee so often, the one positive is that I do not have any times where it takes time for the flow to start. It is immediate.

Hopefully the frequency will decrease from here.

Thank you for your in depth blow by blow description. I have learned a lot from this patient MB, as I ALMOST took the leap to Rezum. That was all my Euro recommended. I have the typical BPH constriction exacerbated by an enlarge protruding median lobe. As such, only take medication flomax and myrbetriq. With prostate around 40 cc, and median lobe, doc said no Urolift (to my dismay), AND the horrors of catheter and self administered cat, I am at a stand still. I have some leakage, but No UTI. I still have the urge to pee, and must have toilet or facsimile (driving and such). Quite embarrassing. Very concerned that I am not hearing all the story, as perhaps someone in the practice has proper certification for medlift or compressed tissue(?) I am looking for easiest route possible(I know no suchthing), least amount of time on cat (maybe NO cat). The number of implants used with eurolift is concerning, as no one knows the number exactly needed for large median lobe to push to one side or other. Thanks for listening, hope for your continued improvement:)

Carl,

I’d look for another doc that is up to speed on your options. Urolift has been approved even with enlarged median lobes for several years now. I can’t say whether yours is of a nature that will make it ineffective, but it’s not a blanket reason to not have the urolift. If your doc says it’s an automatic rejection, then he is not well informed.

You need to talk to someone that can give you better insight into why or why not the urolift would be appropriate for you. As you can see from my recap, mine is not a complete success at this point. But at least I do not fear the need to have to cath to empty the bladder.

FWIW, I had 6 clips implanted. I wouldn’t let the fear of the number of clips control your decision. It means extra cost but I’d rather get one too man clips than one too few.

This thread is interesting, thank you for the updates. I am scheduled in 3 weeks and I decided on Urolift. I was given 2 other options, water vapor and TURP. I am nervous about having it done, but Flomax has quickly lost effectiveness for me (only been on it for about 3 months) and I’m back to having a very weak stream and probably some retention. Also, since taking 80mg Flomax I seem to have no orgasm which is disappointing. I’m still getting up about 2 to 3 times a night to pee.

Sounds like things are getting better for you with time. I’m glad to hear that, I can only hope my experience will be similar.

Good luck with your procedure. Hopefully you will have a positive result with minimal of the complications.

im wondering if any of the pain, and or the other problems, some patients have could in any way be linked to reactions to the metal materials in the clips and anchors etc.

It says on the urolift site that it isnt suitable if you have allergies to stainless steel, titanium and one other i cannot remember.

How would you know?

And i dont think they test you prior.

in the uk it seems very difficult to find an allergy test for that.

Bringo,

While I guess that is a possible explanation for some peoples problems, I don’t think it is a likely explanation for most people. Otherwise, the pain and such wouldn’t go away and the complications would be ongoing. I think most complications are from the trauma to the prostate that is inherent in the procedure. As my doctor explained it, it takes a while for the inflammation to go away after the procedure.

No you’re probably right. Incidentally do they test for any metal allergies?

10 weeks out now and I believe I have reached or am close to maximum medical improvement from the Urolift. I had my final post procedure doctor visit this week. As described in a prior post, there has been some slight improvement over my pre procedure status, having to get up one less time at night than before and not having any times where it took more than a few seconds to start peeing. My retention before the procedure was over 100 cc. Retention at the last two appointments were 23 and 42, which the doctor says is good. I still have to pee more often than I’d like, and I sometimes feel more urgency to do so than I think I should based on the volume. The flow rate is sometimes decent and sometimes slow, pretty much like before.

So, the good of the procedure is that I don’t fear having a situation of being unable to pee and needing to cath. And, the doc says that I shouldn’t have a problem with damage to the bladder that can be caused by excessive retention.

As the doctor worded it, “some improvement but not a home run”. I agree with this analysis. So, it has been better than a strikeout no huge success. If things improve over time, I will update this. Otherwise, it can be assumed that my current status is the best it is going to be.

Good luck to everyone else. We are all unique and will have varying degrees of success or failure.

My doc didn’t.

Like you I had tremendous pain after urolift; I was shaking with it. It was off to the right side and I couldn’t sit due to it. To cut a long story brief, I am still in pain from Urolift three years later and everyday wish I had never had it done. The procedure was only effective for 3 months and I have had to have a TURP anyway which, compared to Urolift, was a walk in the park.
I have had an MRI scan for the pain but apparently the far clip ends don’t show up so no conclusion. One clip end in the Urethra (out of 5) has been removed but no change. As I am on the NHS, the wheels turn very slowly but I have another appointment later this month. I would say the pain now is mostly a 1 out of 10 sometimes rising to 2 or 3. My conclusion is that the body cannot properly heal with metal clips and wires in soft tissue.

I had the Urolift procedure 10 days ago and I am suffering similar effects, the main one being that post pee burning sensation for about 7 minutes in the prostate area.
I am 54 years old and had been suffering from the same kinds of urinary symptoms, a thin stream, getting up 5 times a night, frequent urination about once an hour, having to wait and push hard, etc.
They did the procedure in a hospital under general anesthesia. I had been worried about the anesthesia but that part was a breeze, they injected some orange thing into my IV line that made all my worries go away, then they told me to breathe in some gas which smelled weird and after the second breath I woke up in recovery. They put in 4 clips.
After the procedure, I was immediately able to pee better but not like when I was younger, just a better thin stream. The first day I peed pink tinged by blood and clots but those went away by the second day. The worst part was the burning! And not so much the urethra like the normal discomfort I have felt before after every cystoscopy for about 3 days, but the post-urination burning by the prostate area like someone is inserting a needle into it, or pressing it with pliers. Like you, even my rectum hurt and caused me to have the feeling of having to defecate, without much coming out.
This is somewhat better now 10 days post-op, but I am stil getting up 4 times a night, having to pee every hour during the day, and feeling the need to be near a bathroom all the time. The cycle is that after I pee, the burning is very bad for 5 minutes, then slowly dissipates for 15 minutes, then as my bladder fills, I already feel the need to go but I hold it. The most I’ve been able to hold it is about 1 hour then I pee about 150 ml only.
After 6 days I saw my doctor and he said that my prostate was still inflamed and gave me a dexamethasone injection. I’ve been taking 400 mg ibuprofen every 8 hours. I am hoping I will improve.

I posted in another thread, but I’ll do so here as well, since it’s a bit more recent.
I’m 3 days post-op from a urolift that was performed with ZERO anesthesia. I’m envious of everyone here who was put under and/or had local anesthesia. I had a valium and a vicodin, which did nothing. It was beyond the worst pain I could have imagined. I screamed, hyperventilated, shook uncontrollably and, I found out later, actually went into shock. I quickly developed non-stop a-fib in my heart, which lasted all weekend. Had to go to the ER yesterday. Good thing I did, as I was on my way to either heart failure or a stroke. They managed to get me heart back under control and I’m doing much better today, albeit now taking a baby aspirin daily, along with a HR lowering med, if needed. Seeing a cardiologist tomorrow.
As for post-procedure results, it hasn’t been too bad. I peed blood & clots for only about a day. Like everyone, I still have the bad burning as the pee is on the way, while I’m going, and for a couple of minutes after I finish (which is the worst of the burning). I tried Azo for a couple of days, but it didn’t help much.
Like someone else mentioned here, I also discovered that it’s easier to go standing up than sitting.
My stream is unbroken and pretty consistent so far, but not terribly strong. Ends in a dribble, and a couple of pushes to finish. But it’s certainly better than having a catheter!
I feel an occasional jabbing sensation near my prostate, but haven’t felt it today. It’s hard to tell, but I don’t believe I’m retaining much urine currently.
The night after the surgery, I got up 20 times to pee (not an exaggeration). Night two was 6 times. Night three was 4 times. I’m hoping tonight continues the downward trend.
A little back story about how I got to this point. I’m 54. Back in 2017, I was diagnosed with BPH. Didn’t seem to be too bad at the time, just had to get up a couple of times a night to pee, and had a weaker stream. Fast forward to a month ago. I started feeling horrible and could tell I was retaining urine. Went to the clinic and learned that after voiding once, I still had 400ml in me. Went twice more and still had 250. That required a foley catheter (hurt like hell to get in, due to a very constricted urethra), which I wore for 4 weeks. Got a nasty UTI during that time and had a horrible reaction to Levaquin, so switched to Amoxicillin, which worked fine. My urolift was actually scheduled for Nov. 19, but due to my condition, and a cancellation, I got in earlier.
It’s way to early to know if this will work for me, but I DEFINITELY would not get it re-done without anesthesia. My 82 year old dad was scheduled to have one done this week. I don’t believe he would make it, without anesthesia, since it nearly caused my heart to fail. And, aside from the prostate issue, I’m healthy and fit.
I’ll report back at my 1 week mark. I was hoping to attempt a little romance with the wife after a week or so (it’s been too long, thanks to the stupid catheter), but after reading some comments about that, I’ll be happy to wait a few more weeks.