Had a Urolift procedure several months ago with limited success. Still doing CIC and taking Rapaflow (every other day since I don't like the side effects). The Urologist who did it recommends giving it one more try to see if more pins would help (can only put in a limited amount each time due to insurance). Also saw a Rezum specialist for a second opinion, had another cystoscopy and he thinks Rezum could help and would be more effective since part of my problem is the prostate pressing into the bladder. 6% to 10% chance of RE though. Interestingly the Rezum Urologist thinks it's due to the median lobe but the Urolift Urologist doesn't. Maybe they just see what they want to see. I've posted a few times previously and know people have their opinions and biases and there are other options, my main questions are if anyone has had or heard of a Urolift repeated with any success, or Rezum after a Urolift. Thanks!
"Interestingly the Rezum Urologist thinks it's due to the median lobe but the Urolift Urologist doesn't. Maybe they just see what they want to see."
The Rezum guy is right, the UroLift guy is way wrong. If you have a median lobe, UroLift, although recently approved for median lobe, is not the best option.
Hey buddy
Sorry that you have to go through this. If that would have happen to me I would have tried it. I had 4 put in no problem.
How many have you had. I know they can go up to 8. If you do have a median lobe issue may this time he can clip it to the one side.
There was a guy on here called Chuck years ago. He had his Urolift done before me. He only have 4 the first time. Was not good flow. He had another 4 put in and it worked fine.
I would give it another try. You can always have the other done if it does not work.
Ken
To add, this is a perfect example of what I've vented on this site before - that Uro's only care what is good for them, not the patient. In this case, a failed Urolift Uro wants to try again with a person with a median lobe - Fire that Uro!! This is probably because this is the only so-called non-invasive procedure this guy offers - he's doing what is best for him, not the patient = SHOCKING!
Well not going to get into it.
All I have to say is To each his own.
How can you say one is right and one is wrong and which one. You don't know.
Your not a doctor
God help us all......Ken
We are only giving our opinion We just hope all works out for everyone
Buddy
You can say the same about the Rezum doctor
He has a median lobe Ken... Bad advice. UroLift is not optimal for median lobe obstruction although approved for it..
How old are you? Do you care if you have Retrograde Ejaculation? If you don't care,get the real thing which is a HoLEP procedure
We can say anything, but the in this case, considering median lobe, the rezum guy is dead on. Do you understand median lobe pathology? I can't say whether Rezum will work for this guy or not. I can say with 100% certainty that in this case, the UroLift Doc is flat out wrong. UroLift has a much smaller chance in working correctly when a median lobe obstruction is present. Furthermore, it depends on the IPP level of encroachment into the bladder. In other words, his median lobe can be stapled to one side, but if it's encroached too far into the bladder, while his flow rate would improve, his irritative symptoms would likely get worse = more frequency and urge.
A big part of what I do for a living is to analyze dev. biotech and new and upcoming medications and procedures. A lot of my 'clients' are in fact Doctors:)
100% agree Joseph.. That or GLEP - basically the same thing with a different laser.. Holep and GLEP are the true Gold standards that consistently beat TURPS according to all the literature I've read.
Let him try. It is up to him.
My doctor has done men with median lobe. All you have to do is clip it to one side. It would do the same relieve the pressure off the bladder neck
Rezum has not work for all men with median lobe. We never know what is going to work.
That is the way life is. I hope what ever he decides will help him
Oy, yoy, yoy Ken!! .. Again, it depends on the degree of encroachment of his median lobe into his bladder. All he has to do is ask both Uro's is how far the degree of encroachment is. A pelvic ultrasound should be able to tell. If not, then a TRUS will definitely be able to tell.
It's not as simple as simply stapling the median lobe to one side. If small encroachment, it could work. Generally speaking, Rezum has a better shot at working for median lobe protrusions. If he's not concerned with retro, ditch both and get a Holep or GLEP :)
Lvscott
Thank you for that information. But we can agree to disagree. Because in the long run it is not up to us
I give my views on my procedure you give your views on your.
But we can't make DB's decision. All we can do is stand by and hope that what ever his decision is that it is right for him and his concerns.
That is all we can hope for anyone.Ken
Yes I know.
He should get both doctors opinions. He does need the information and test to tell what the story is.
No man should have any procedure until all test are done. It may not even be the prostate. He may have a bladder problem. No one knows.
But in his favor he is doing the right thing by going and asking question to both doctors. That is his best shot for relief of his problem.
Sometime we have to go step by step. It's like a shirt. Some may fit your body but will not feel right so you keep trying on different style until you find the right one.
I guess life is that way...Ken
lots of opinions on this subject. its a tough one. most docs have a prefered procedure they like to do and are good at. maybe a third opinion is needed. kinda sounds like more testing may be needed. good luck with whatever you decide to do. please keep us up to date on what you have done and the outcome.
I'm 55, my main reason for trying Urolift originally was because of no RE. I've had it from the meds and while I guess I could get used to would rather be able to ejaculate. I've heard from others on this site about GL with ejaculation preservation technique, don't think there are any specialist around my area. I have a somewhat weakened bladder from having retention for a long time without knowing it. I've got some pressure back from the CIC but not all (yet?). Thanks everyone for your comments!
if you notice there are a lot of unhappy resume and urolift customers on these threads. I really don't see anyone complaining about bipolar turp or holep. I assume they're all satisfied customers and have moved on with their lives.
DB,
Did you have the new Urolift procedure for median lobe? It sounds like your Urolift doctor did not check for median lobe before he did the procedure, and he should have. For about 5 years median lobe patients were excluded from the Urolift procedure. Early in 2018 a new procedure for median lobe was approved after a one year clinical study showed it was effective. If your Urolift doctor just wants to add more clips I would not do it, unless he plans to do the new Urolift, Medlift procedure and pin the median lobe to one side with a clip. From a conversation I had with a NeoTract (the Urolift company) representative, they are sending a team of experts to assist doctors with their first Medlift procedures. Unless your doctor has had that training I would not do it with him. Look at the Urolift website and find doctors in your area who do Urolift and call the to find out if they have done the new Medlift procedure. It may be that they can add just one clip for the median lobe and you would improve.
Thomas
db, you are doing CIC so do you know how much your retention PVR is . If it's significant, according to trial data results, neither Urolift nor rezum will do. Either HolEp or bipolar TURP or CIC are your best choices. Hank
John & DB
It would be a good idea to get more information. If he can add the clip and pull it to the side it would open you up like you need.
It is good to start with the less evasive procedure. If this does not work you can go to the next procedure. It is all up to you
My doctor has been doing the median lobe Urolift for 6 month's with good results
But you need to look at all your option and also voice your concerns to your doctor.....Ken