69 yr old - BPH - P infections since 1983 2/3 a year. negative DREs; bactrim or doxy for infections 2011 bleeding start w infections 2015 CT shows bladder stones-cysto removed 2017 peed out bladder stones 6/2019 urine retention - ER - Foley Cath - began Silodosin 7/2019 CT shows P at 200ml Dr says stay on meds until doesnt work - then, Simple Prostocomy surgery will be needed Says FLA, Tulsa Pro not workable due to P size Inquiring about how to prepare for this step if i have to do this surgery: 1. Experiences 2. side effects - how long 3. would you do it again 4. how long to being normal again 5. if y had- did infections n bleeding go away? 6. any tips or word to the wise? Mike
Mike,
I would get some second opinions from Urologists, Interventional Radiologists, and other people. A urologist will never recommend FLA because it is done by a different group of doctors, Interventional Radiologists. To get a better opinion about whether it would work on a 200cm prostate contact Dr. Karamanian in Houston Texas.
Have you thought about Prostate Artery Embolization (PAE). It can work on large prostates. But again it is done by Interventional Radiologists, so ask them about it, not a Urologist.
Whatever procedure you do, make sure the doctor has done many of them, even if you have to travel.
Thomas
Hello, Mike:
There are only about 2-3 of us on this forum that has done the Simple Robotic Prostatectomy (SRP). For the most part, everyone else views this procedure as too invasive and the last resort, if a consideration at all because it scares the heck of them, or not offered where they live, or too expensive.
About 15 months ago (Aug 2018) I did mine and I absolutely have no regrets, and to this day, pee like a young man (I am 62 years old). When “size” is the problem (mine was 265g), and full retention impacts your life (I was on foley for most of the summer of 2018 because of acute retention), this procedure solves that problem and restores that one bodily function that is so important in our lives - peeing normally. I have no urgency, frequency, or incontinence issues. I sleep through the night and can still have an erection.
Private message me and I will share the picture of what my doctor carved/shelled out using robotics. The robotic precision will amaze you, AND, my sphincters, bladder neck, nerve bundles, and urethra were never disturbed.
As for your questions, I will be glad to answer those later today when I have some more time and share with you my experiences with this procedure. Getting ready for work right now and have to go. Stay tuned.
Dave
Mike - I went back and reviewed my messages and it looks like we have already had a pretty good conversation. I also shared with you my pictures. Please let me know if you have any other questions/concerns and I would be glad to answer.
Dave
I have already replied to you about this.
I would seriously look into Holep as an alternative. It may be just as effective as simple prostatectomy without being anywhere near as invasive.
Holep can be done in an outpatient surgery center with spinal anesthesia rather than general anesthesia.
The catheter is removed the next day.
The recovery is much quicker.
I wouldn’t consider something like PAE given your history of chronic prostatitis which is similar to mine. I consulted with an interventional radiologist who does PAE and he didn’t feel optimistic that PAE would help my chronic prostatitis based on his experience.
PAE is good for people with BPH without a concomitant history of prostatitis.
The urologist who is doing my holep next month agrees with this. He feels it is important to remove prostate tissue to address chronic prostatitis along with BPH.
yes y did reply earlier Dave. I was interested in anyone else’s experience. Do you have an eMail for Dr Cross? Later, i know y are at work
mike
Thank y Thomas for the reply. I am indeed researching all options. If i do head in the Simple P surgery route i want to consider all members comments - espec those who have had this type of surgery.
Mike
The other person on this forum is Feral, and one more, but I do not recall the name.
I do not have his email. Try reaching out to his office (see our previous private message).
Dave
I mailed an inquiry to him today Dave.
Tks
Mike
dan,
i have an appt w a respected urologist in New Orleans mid January to explore options for a 220ml sized P.
Hopefully i can anchor down some options w my visit.
I want to burden myself with information n options
Tks
Mike
Yes, I am the beneficiary of a Simple Robotic Prostatectomy. Like Dave all my Prostate issues fell away quickly after the operation. I had one instance of incontinence the first day home, had some blood in the urine for about a week. Mild pain briefly handled by Tylenol. Now 6 months later have difficulty even remembering the suffering I went through prior to the operation. My prostrate was over 200Gm which limited my options. Holep was not available to me because of insurance issues. I was offered SRP or the old open Simple Prostatectomy which is the surgeon opening me up and doing it all by feel which leads to way more possible complications. It sounds scary but surely it is one and done, at 76 I will not have prostrate problems again.
Hi Feral - Music to my ears. I am glad we are not suffering anymore. One and done is so true. BPH is a distant memory.
Dave
Great news Feral. Did y also have many infections w bleeding and bouts of bladder stones? Thats where i am now…Was y RSP surgery done in Ca? with whom? How did y find him?
No bladder stones or bleeding, more run of the mill getting up 4-5 times night to pee, sudden urge to pee that can’t wait, medication that caused RE and other side effects. Just a real quality of life issue. I had the help of my doctor, saw 5 different urologists and finally on his recommendation saw a urologist part of a cancer group. He operates on prostrate cancer patients and has performed many non-cancer Simple Robotic Prostatectomies. He is Julian Anthony MD and practices in North San Diego county where I also live.
I had a bad anesthesia reaction brought on by my age and about two dozen prior operations with full anesthesia to repair damaged bones. I worked construction for 50 years and had a couple of nasty accidents. The SRP was a piece of cake and one of the best things I have done for myself, the anesthesia issue while not caused by the SRP operation was no fun.
So glad to hear of a successful fix. Hopefully i can decide what to do in the coming year after exploring my options.
Seems like a uro with cancer focus is the route to explore since they do so many radicals w some doing the robotic. Glad y are doing well…oh, did y ever do Finstaride n if yes - how long? I have been avoiding starting that. Only doing silodosin 1/day w no SEs other than retro into bladder.
Want to give u guys an update. I contacted Univ Finland Hospital dr about Tulsa Pro for my 220ml size P. Germany n Finland have been doing for yrs w good outcomes for P cancer n BPH at a cost range of $17-22k us dollars. Respected Dr at Finland advised that Tulsa Pro is not a fit for a P larger than 100g. He was not an advocate of other interventions. So i continue on meds for now n continue exploring robotic SP surgery experts. Mike
Dave,
I’m considering Robot Assisted Simple Prostatectomy. My prostate is 220 g and I have full retention. Is there any way you can share your experience with me?
Gary
Feral
Did you have incontinence or ED
Gary
Hi Gary - I sent you a private message.
Dave
I don’t often return to the forum as my prostrate problem was solved. Today just thought I would have a look and see how or if things have changed. Seems all threads about TURP and other remedies are still going strong. I can remember the stress of an enlarges(220g) prostrate, having it reduced by about 200g has changed my life for the better. Now I just suffer from being an old man getting older where running is a faint memory and falling down is my biggest health threat. I do get in 2 miles a day walking which helps keep my wheels working.
Now back to the results of reducing my prostate by robotic surgery. Back to sleeping 8 or 9 hours without getting up to pee. As a health issue I try to drink lots of water. This does cause me to pee several times a day but there is no real urgency, I an able to hold it for a long time if I’m driving or not neat restroom. As reported I had one time of incontinence the first day home which caused the purchase of a package of adult diapers which now sit on the shelf collecting dust. I have returned to pre-BPH with reference to ED. Not as hard as when I was 20 or or inclined to stay that way for as long as I want but it does work and is still an important fun toy. RE or no ejaculation has not been a problem though the ejaculate is thin and clear at lest partially associated with a vasectomy (I can confirm it is not pee). So there you have it my report on the results of having a SRP.