Urolift my experience: 75gm prostate 7 tags

Men's health
1

I had a Urolift procedure 3 days ago.

Background

I have had an enlarged prostate with the attendant common symptoms for about 7 years or so. Initially my PSA went up and was pressed to have prostate cancer biopsies, which I resisted for about 5 years. Eventually when my PSA went up again a little abruptly, I succumbed to the pressure to have biopsies 18 months ago. I had an MRI scan (self funded!) and then targeted template biopsies which gave a negative result.

After the prostate biopsies, I began to suffer sometime very weak flows to the point of temporary urine retention. I have been taking an alpha- blocker (alfuzosin hydrochloride) since then – actually I am not sure it helps much … I declined to take a 5-alpha reductase inhibitor because I did not relish the side effects. At that time I had a prostate size of 74cc according to the MRI scan.

I was measured to have a flow of about 8ml/sec voiding about 175ml, with little left in my bladder. My IPSS score was 21.

My consultant introduced me to the Urolift procedure as a possibility. I also investigated prostate artery embolization with a potential ability to get on the UK trial – but my consultant (urologist) was very much against it. Despite the fact that my prostate is at the top end of the scale for Urolift, I eventually went for that option.

The Procedure

Under intravenous sedation I had 7 tags put in. The surgeon said afterwards that it went well technically, but that the affect on my symptoms was not predictable. I was able to void 180mls and 200mls in the recovery room according to the nurse – this was as I was coming round, so I went home without a catheter. I was given intravenous paracetamol and a morphine shot in the mouth for the pain, although the consultant said that the morphine would not help ...

Initial reaction

I had a bad time as I had to go to try to pee every 15 minutes all night and some of the next days. Often it was a very small amount (10mls or so) mainly blood. I rang the hospital and a duty nurse suggested that as long as some of the liquid was urine then I should tough it out – which I did, rather than coming to A&E for a potential catheter.

I managed to contain the pain with paracetamol and avoided taking codeine as I was concerned about being constipated.

For the next two days taking in a lot of water, I had feelings of unstoppable urgency every 20 minutes or so through day and night only able to void about 90mls at the most, the stream being poor and stopping frequently. My penis would sting sharply each time. After this time though the urine had turned to rose colour and then clear (almost). At one time out came some blood clots but the stream did not improve thereafter.

Current Situation

It is now 3 days since my procedure. For about 24hrs I have had little pain most of the time, and have not taken a painkiller. However every 40 minutes or so, sometimes much less, I feel I have to go and about 90ml is about the average. The urgency feeling seems to be felt in my penis itself.

The stream is poor, it interrupts often. I think that my bladder is not emptying as well as before. My penis itself aches badly just before and after urinating. I find that there is pressure from the back passage and when I fart I hurt behind and between the legs.

I know it is 'early days' but I am worried that my symptoms are much worse than before, and particularly there are no hints of a better flow, quite the opposite. I have been influenced by my consultant who had played down the effects of the procedure itself, and even talked of people having immediate improvement the next day …

I will post updates.

2

Hey Mike:

Hang in there!  I hear it takes two weeks, maybe four weeks or more to start seeing results.  

Rome was not built in a day!  Hang in there.  Urolift has had some grerat results.  But the recovery can be painful and discouraging - from what I have heard.

Where did you get the procedure done?

Best,

J.

3

I'm 17 days post op urolift.  Hang it, it does get better slowly.  My mistake was going back to work too soon.  Best to rest.  Its a major insult to the body and takes time to heal.  My doc said should be mostly well after 30 days and completely healed in 90 days.  I posted a running progress report on another thread, or maybe a bunch of other threads.  This forum can be confusing.  Bottom line, rest and heal - its worth it.

Pretty soon you'll pee like a drunken teenager - and be ejaculating like one too.  Worth the ordeal for sure!

4

Hello mikemh,

I can appreciate your fairly early concern.  However I think from what I can gather reading various posts on this forum about such a procedure, three days is pretty early doors to expect any significant symptom improvement.  Although of course I do take note of your comments about the somewhat present negative early post-operative symptoms.

After reading quite a number of forum posts about symptoms following the Urolift procedure I suspect your influencing consultant was somewhat overly optimistic. 

Although I have read perhaps one post on this forum of a virtually immediate improvement in symptoms.  So these immediate improvements I believe are very few and far between!  

So from my limited experience I would think you need to give it a few more days , maybe even weeks, before anything remotely certain can be ascertained as to long-term success or otherwise. 

As maybe you already know from many of the contributors to this forum you'll hopefully subsequently receive some useful and encouraging information.

As for my own current situation . About a year ago following a PSA check at the local surgery, which came back as 6.6.  I was subsequently diagnosed as having BPH and following another finger check of my prostate this time at hospital, I was nearly booked in for a biopsy check.  I say nearly because I said no thanks.  Also similarly to yourself, I subsequently decided to self fund an MRI.  (Which cost about £500)  As I say, that was almost a year ago.  

Anyway following something of a diet change and a little increase in exercise, my last PSA check about six weeks ago came back at 5.1.  Out of interest, may I enquire what kind of level your PSA were/is?

5

Hi Chip.

Thanks for your support.

I am in the UK and got it at Frimley Park Hospital by the main guy over here.

Best Mike

6

Hi

I sure hope your are right about the drunken teenager!

Yes there are quite a few different but similar forums.

I'll look out for your running report too

Good to have friends here

Mike

7

Hi Ben

Thanks for you post.

I paid £1000 for my MRI !!  That was because a consultant referred me to a place in Harley Street London - but I am glad I had it.

My PSA was much higher.  It climbed to about 13 over about 7 years but results were negative.

So your figure looks good to me.  Pro rata with a big prostate your PSA seems really low.

 

8

Unless your consultant has undergone the procedure himself he would not know how a patient really feels and therefore he would downplay it. He does not want the patient to back out.

9

My PSA over ten years went from 5.1 to 9.8 as my prostate grew from 35gm to 75gr.

Two early biopsies were negative and I did not bother with more as each caused a long term infection..

10

Hi Mike....sorry to hear of your situation. I really sympathize because my story was identical to yours in most respects. 

I too had elevated PSA....was sent off to urologist who pressed for 30 core trans perineal biopsy. 

I reluctantly agreed  but that's when my troubles started. The biopsy caused me to have urinary problems that I didn't have before. Slow flow,, no flow, getting up at night 6 times. etc. 

I was put on flomax but what shocked me was that basically the urologist didn't care. It'll pass he said....it didn't, but meanwhile kept raking in the cash from all the other poor fools who crowded his waiting rooms. 

i saw two other urologists ....one was a woman ....she wanted to do open surgery on me for BPH for gods sake!  The other wanted to do a Holep. I was pretty much set to have this done but then I heard about PAE.  Long story short I had my PAE three months ago añd all my symptoms have disappeared. 

The point I am trying to make to anyone reading is to be very very careful of urologists. I wonder how many there are who have had their quality of life seriously impaired because a urologist pushed a biopsy on them. As you can gather I have a very low opinion of urologists. 

Mike it's early days yet. I'm really hoping for a good result for you. 

11

Don't believe UROLOGISTS--they dismiss PAE, as they fear they will loose the livelihood. But I am not yet clear about the procedure, and I am yet to find somebody with GOOD results with UROLIFT done.

Will wait for your UPDATES.

12

I tend to agree with you about Urologists but I went for Urolift rather than PAE because it was 'reversible/less intrusive' and seemed likely to have less potential nasty issues.  For example, I was unsure that blocking off the blood flow might have some long term issues...

 

13

Hi Mike....my prostate was too large (120cc) for Urolift. I was seriously considering it but what swung me in the end was that I had prior successful experience of embolusation about 25 years ago. I had a artero venal malformation (AVM) at the base of my skull. It was inoperable but fixed by interventional radiologists who embolised it thus saving my life. 

I wasn't criticizing your choice of Urolift ....I think it's a good procedure and I really hope you are feeling better soon. 

14

What is PAE?

I have heard of Urolift, Ejaculate Preserving (EP) TURP, TURP HOLRP, Green Laser.  

But PAE?

I have a large median lobe blocking the bladder neck.   Urine flow weak.  

I am taking Flomax.  But eventually I will need surgery.  

15

Hi Chip

It is Prostate Artery Embolization.  It is being trial in various countries including US and UK.  There are threads about it on this site  eg https://patient.info/forums/discuss/has-anyone-out-there-had-a-prostate-artery-embolization--301859?page=0#1613618

Mike

16

Prostate Artery Embolisation is the procedure whereby an interventional radiologist (not a urologist) partially blocks the arteries leafing to the prostate causing the prostate to shrink thereby relieving BPH symptoms. Read the threads here ...there is a ton of stuff or google it. 

I had mine three months ago...no cutting, no bleeding, no retrograde ejaculation, no impotence, no incontinence, strong urine flow. Best thing I ever did. 

17

Any word as to how long PAE might last, what is the recovery time, and how many doctors do it?

18

Its a new procedure ...only been done for about three years....I may be mistaken there. So it's at least three years. I was fully recovered in about five days....again read the whole thread for everyone's experiences. 

19

I was told that Urolift is the only procedure without negative sexual side effects. PAE has none?

20

Was it a urologist that told you that? PAE has absolutely no sexual side effects except for 30% of PAE patients who report improved sexual performance. I was lucky enough to be in that category. Fuller flaccid penis and better erections. 

Dan, you were told incorrect information. I have never heard of anyone having negative sexual side effects without PAE.

It would be fair to say that Urolift is the only UROLOGIST PROVIDED method without negative sexual side effects. The urologists are very defensive about PAE as it has the potential to smash their incomes. As time goes on I expect that PAE will become the norm.