I've recently noticed the number of men in this forum who are opting for the TURP procedure, rather than some of the less invasive BPH procedures (such as Green Light), and I'm wondering why. I know that for some men, PAE, the newest and least invasive procedure of all, is not an option or has been tried and hasn't worked, and that for these men the only surgical option is one of the techniques that has been around for a while. But why TURP? I thought there were other more recent procedures, such as Green Light Laser, that were just as effective but less invasive? I'm not questioning anyone's decisions. I'm wondering if there's been a shift among uros back to the old tried-and-true TURP (which my father underwent successfuly 30 years ago) over Green Light and other alternatives to TURP. Thanks for any information you can pass along.
One would think that from reading this and other Forums that they would know better.
There are now several improved versions of TURP but urologists tend to call any of them TURP. I even have a letter where a urologist said that I had a Laser TURP in 2005.
If you are in the UK the first choice by NICE is now the improved Green Light version GL XLS.
As I've posted elsewhere, my green laser TURP 7 months ago has been anything but successful. I have full incontinence, using 6-8 pads and diapers each day and I am not sleeping any better than before. BTW, I think the GL procedure meets the definition of TURP. Rather than resecting in slices, it burns away the prostate to small fragments, whereas some others cut it into slices.
It seems like most of the men who had a TURP did so because that was the Only Treatment their urologist knew or recommended...Then, after the TURP, most all of them had complications, which in some cases, may be irreversible...
Research HOLEP it has its down side but seems to be a good alternative to standard TURP
Don.....I’ve been following this blog for about 9 months and have heard a lot about cathing, drugs, and the various BPH procedures including PAE, Rezum, Urolift, TURP, Green Light Laser and HoLEP. The following summarizes what I’ve read as best I can.
Some procedures seem to work for some but not all. Worse yet, some have reported total incontinence after their surgical procedures. It’s hard to tell if it was a botched job or not.
The best answer imho is surgery, specifically HoLEP. I did the research on all the procedures (except PAE….had not heard of it), and chose HoLEP. It is the best surgical procedure because; 1) less time in the hospital and a on catheter (less than 24 hours), 2) less bleeding, 3) very small chance of needing a repeat procedure, and 4) they remove prostate tissue (instead of burning or otherwise destroying it), so they can biopsy it for cancer. I have heard no reports of anyone having HoLEP and needing a second procedure or experiencing incontinence or needing to continue cathing. I’ve heard way too many horror stories on this blog about TURP & GL. My uro explained that they both burn the tissue out, and therefore leave scar tissue. That tends to shrink over time, and hence the need for a repeat procedure. With HoLEP, they cut the tissue away, grind it up with a ‘morcellator’, push it into the bladder, and then wash it back out.
Yes, you the have retro ejac, but sex drive returns, and since I don’t plan to have any more children (age 68), it’s not a problem for me. I was retaining close to 800ml, and my prostate was 85 grams, PSA 3.8. After it was 46 grams, PSA 0.2. I had my surgery in January, and after two to three months had no problems at all. I did have leakage for 3 or 4 weeks. Some in the UK report they were told to do Kegel exercises for a few months before surgery to avoid this.
I have heard varied reports on PAE which is done by interventional radiologists. It is an outpatient procedure and far less invasive. However, I don’t believe it’s covered by most insurance, and because of the iffy results, don’t think I’d try it.
Lastly, the experience & ability of the doc is critical, and often difficult to determine. Hospital ratings for various specialties can be found in the US News & World Report evaluations. Bios for docs may or may not be available. For example, the Mayo Clinic was rated best in the nation, and they have the education and publications of their docs listed…… very helpful. Best of luck!
As I've mentioned my lengthy and sever incontinence to the point, I fear, of sounding like a broken record, I must in all fairness repeat an important statistic. In a paper by Dr. Drogo K. Montague of the Cleveland Clinic, he wrote, "Urinary incontinence occurs less often (than for a radical prostatectomy) after transurethral resection of the prostate being a significant problem in only 0.5% of 3885 men 2 months following surgery." So I'm apparently one of the unlucky 0.5%.
Hi Paul, I'm a bit confused did you have HOLEP? You say your prostate was 46 grams after HOLEP, correct? Gee, mine is only 50 grams to begin with. Other than leakage how long before you were trouble free after surgery? How long after surgery until could you have sex?
For one thing, the recovery period for the less invasive procedures can be 6 months or more for full normal. Had my doctor told me this before the procedure I probably would have gone for traditional with much shorter recovery.
Thanks for the thorough report, Paul. Sounds like HoLEP has worked well for you. My uro here in Washington DC is one of the top docs in the area and a very nice guy to boot. But I don't think he does HoLEP. I'll continue researching the issue. In the meantime, my meds--Finasteride and Cialis--still work reasonably well, so there's no urgency, but at some point I'd like to be drug free. Here's wishing you continued improved health.
Very sorry to hear about your unfortunate experience, Glenn. What are your options at this point? One thing I don't understand about your procedure. You described it as a "Green Laser TURP." I thought Green Laser and TURP were two different procedures. Is there now something called Green Laser TURP?
Yes, from what I've read so far, it does seem to be a good alternative to both TURP and Green Light. Thanks for weighing in.
Hi Don, How long were you on finisteride and cialis,glad to hear it works for you?I have urine rentention , been on Avodart,and flomax,4 months,still have a cather in.,still canot urinate.Did you have urine rentention?How soon did the medicine start to work for you?
thanks for this info/
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I just view it as a variety of TURP. Instead of the resection via cutting, the laser vaporizes prostate material. My second procedure was Gyrus TURP. Some urological centers call it Gyrus TURP, and others call it Gyrus Bipolar Electrovaporization. Just a matter of naming.
Don, I did the greenlight laser back in 2005. It was OK for two years, then I had to go in and do the regular TURP. The regular TURP, lasted longer and had better results. It could be that my prostate, was very large at the time, and that's why the greenlight, wasn't that successful. My prostate, before the TURP, was 141 grams. After the TURP, it was 101 grams. I recently did another TURP, about two months ago. The surgery, was not successful. I am now self-cathing. Hope this helps.
Guys To me it seams like these procedure are going a rye. Why do men keep on having surgery after surgery for something that is suppose to fix the problem once in for all. Maybe the new ones will work alot better. I hope so. How many time can you have a turp Before there done cutting away they will be down to the bone. I feel sorry for all the men that have to go through this. Take care all Ken.
Unfortunately, the prostate, keeps on growing for some of us. The Holep surgery sounds like a pretty permanent one, according to what I've read on this forum so far. Lets hope they come up with better solutions in the future.
Yes Dennis that is true. I'm 61 Had a urolift done in April of 2015 Just had it checked a few week ago. Mine got smaller my urologist don't know why PSA was 0.7 so I should be good till next year....They are working on some new one that should be good Take care Ken
Wow Dennis I feel bad for you. Did the DR explain why the prostate was so big after turp and why these procedures aren't working? Are you planning another procedure to fix the need for self cathing?
Seems to me urolift is just "pinning back" the prostate since no tissue is removed. Maybe the compression of the gland causes tissue to die?. If it keeps growing it will eventually be a big problem.